[18F] Altanserin Bolus Injection in the Canine Brain Using PET Imaging

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[18F] Altanserin Bolus Injection in the Canine Brain Using PET Imaging Pauwelyn et al. BMC Veterinary Research (2019) 15:415 https://doi.org/10.1186/s12917-019-2165-5 RESEARCH ARTICLE Open Access Kinetic analysis of [18F] altanserin bolus injection in the canine brain using PET imaging Glenn Pauwelyn1*† , Lise Vlerick2†, Robrecht Dockx2,3, Jeroen Verhoeven1, Andre Dobbeleir2,5, Tim Bosmans2, Kathelijne Peremans2, Christian Vanhove4, Ingeborgh Polis2 and Filip De Vos1 Abstract 18 Background: Currently, [ F] altanserin is the most frequently used PET-radioligand for serotonin2A (5-HT2A) receptor imaging in the human brain but has never been validated in dogs. In vivo imaging of this receptor in the canine brain could improve diagnosis and therapy of several behavioural disorders in dogs. Furthermore, since dogs are considered as a valuable animal model for human psychiatric disorders, the ability to image this receptor in dogs could help to increase our understanding of the pathophysiology of these diseases. Therefore, five healthy laboratory beagles underwent a 90-min dynamic PET scan with arterial blood sampling after [18F] altanserin bolus injection. Compartmental modelling using metabolite corrected arterial input functions was compared with reference tissue modelling with the cerebellum as reference region. 18 Results: The distribution of [ F] altanserin in the canine brain corresponded well to the distribution of 5-HT2A receptors in human and rodent studies. The kinetics could be best described by a 2-Tissue compartment (2-TC) model. All reference tissue models were highly correlated with the 2-TC model, indicating compartmental modelling can be replaced by reference tissue models to avoid arterial blood sampling. Conclusions: This study demonstrates that [18F] altanserin PET is a reliable tool to visualize and quantify the 5- HT2A receptor in the canine brain. Keywords: Canine brain, Kinetic modelling, 5HT2a receptor, Mood-disorders Background the pathophysiology of several neurological and psychi- The G-protein coupled 5-HT2A receptor is the main exci- atric disorders including depression, anxiety disorders, tatory serotonergic receptor in the brain [1, 2]. Studies in personality disorders, obsessive-compulsive disorder, bi- humans and rodents found the highest densities of 5- polar disorder, Alzheimer’s disease and schizophrenia [2, HT2A receptors in the cortex, mainly in frontal regions. 5–13]. Positron emission tomography (PET) is an inter- The hippocampus and striatum exhibit lower densities of esting tool in brain imaging research, permitting the the receptor, while the cerebellum is virtually devoid of 5- visualization of the 5-HT2A receptor in the living brain HT2A receptors [1, 3, 4]. The receptor is also widely dis- by using receptor specific radioligands [14–16]. In vivo tributed in peripheral tissues, where it mediates platelet study of this receptor is an important field of research as aggregation, capillary permeability and smooth muscle it improves our understanding of the various diseases in contraction [2, 5]. which the receptor is implicated. Although several PET Besides its influence on numerous physiological func- radioligands for the 5-HT2A receptor have been evalu- tions, the 5-HT2A receptor is believed to be involved in ated, the clinical use of the majority of these radioligands is limited due to low selectivity or high nonspecific bind- * Correspondence: [email protected] ing [17, 18]. Currently, the selective antagonist [18F] †Glenn Pauwelyn and Lise Vlerick contributed equally to this work. 1 altanserin is the most frequently used PET radioligand Laboratory of Radiopharmacy, Ghent University, Ottergemsesteenweg 460, 18 9000 Ghent, Belgium for 5-HT2A receptor imaging. [ F] altanserin is Full list of author information is available at the end of the article © The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. Pauwelyn et al. BMC Veterinary Research (2019) 15:415 Page 2 of 11 characterised by a high brain uptake, high affinity (kd:0.3 (n = 5). High chemical and radiochemical purities of > nM) and high selectivity towards the 5-HT2A receptor 99% were achieved with a minimal specific activity of [19–22]. In human neuroimaging, the in vivo formation of 100 GBq/μmol at EOS. lipophilic radiolabeled metabolites that cross the blood brain barrier complicates kinetic modeling with this radio- Blood input function and metabolites tracer [15, 17, 20, 21]. However, correction for these radi- The parent compound fraction in plasma over time olabeled metabolites can be achieved by the application of (mean for five dogs) is visualised in Fig. 1a and illustrates a bolus-infusion protocol with equilibrium imaging [23] a slow metabolization of [18F] altanserin during the PET or by using a dual-input functional approach [24]butis scan. After 10 min, 86 ± 5.9% of total activity in the not feasible in clinical routine. Besides in human clinical blood plasma was intact [18F] altanserin and further de- PET studies, [18F] Altanserin has been used in studies with creased to 55 ± 4.9% at 90 min. Using HPLC one major baboons and rodents. Unlike in humans or baboons, only unknown polar metabolite (TR =t0) could be identified polar radiometabolites have been identified in rodents [1, which increased up to 41 ± 3.9% at 90 min. Furthermore, 3, 21]. To the authors’ knowledge, PET imaging with [18F] two lipophilic metabolites could be separated from [18F] Altanserin in dogs has never been demonstrated. How- altanserin (TR: 10 min) during HPLC analysis: an un- ever, since they show naturally occurring behavioral disor- known metabolite (TR: 6 min) and a metabolite identi- 18 ders which are related and possibly homologues to fied as [ F] Altanserinol (TR: 8 min). These lipophilic particular human psychiatric disorders, the dogs might metabolites together never transcended 2% of total present a valuable animal model for them [25–29]. In radioactivity in plasma. Thereafter, a Watabe function addition, dogs have a relatively large frontal cortex in was fitted to the intact fraction of [18F] altanserin in the comparison with rodents, which makes imaging studies of plasma for every individual dog and a metabolite- this region more feasible [30]. Previously performed corrected plasma input curve was calculated using SPECT and psychopharmacological studies with dogs PMOD (Fig. 1b). have already reported a potential involvement of the 5- HT2A receptor in impulsive aggression, pathological anx- Brain analysis iety and other affective behavioral disorders [27, 28, 31, A bolus injection of 352 ± 27.7 MBq [18F] altanserin 32]. For example, a decreased binding potential of the 5- showed a fast uptake in all of the regions followed by a HT2A receptor in brain regions assumed to play an im- relative fast wash-out. High radioactive uptake was portant role in the pathophysiology of anxiety disorders found in the following cortical regions: frontal cortex, was reported in dogs with pathological anxiety [28]. On parietal cortex, anterior cingulate cortex and subgenual the contrary, increased binding potential of the 5-HT2A cortex. Moderate uptake was seen in the temporal cortex receptor was found in dogs suffering from impulsive ag- and occipital cortex. The cerebellum represented the gression [31]. These findings emphasize the role of the 5- lowest radioactive uptake (i.e. the reference region). Fig- HT2A receptor in canine behavioral disorders. Using the ure 2 represents a summed PET image (frames 1 to 40) advantages of PET imaging over other imaging techniques co-registered with the MR image. Figure 3 represents to study the 5-HT2A receptor in the dogs, its involvement the corresponding time-activity curves for the different in several behavioral disorders can be further investigated VOI’s and display a fast equilibrium was achieved after which could help to gain insight in the pathophysiology of bolus injection of [18F]altanserin. certain canine behavioural disorders and would help to guide the treatment of these disorders. Kinetic modelling 18 The first objective of this study was to quantify [ F] VT-, BPND- and AIC-values (mean ± SD) for the six differ- altanserin binding in the canine brain using compart- ent modelling methods (n = 5) are added in Additional mental modelling and a metabolite corrected arterial in- data (Additional file 1). Small standard errors (SE) were put function. A second objective was to investigate seen for the 1-TC and 2-TC model with a maximum of whether compartmental modelling can be replaced by 6.56 and 4.47% in the cerebellum, respectively. The 2-TC reference tissue modelling in future experiments, since model showed excellent fits for the target ROI TACs in this would avoid invasive arterial blood sampling and contrast to the 1-TC model confirmed by the remarkable therefore facilitate application of the radiotracer in fu- lower AIC-values observed in all of the brain regions using ture studies. the 2-TC model compared to the 1-TC model. When plotting the BPND-values of the 1-TC model and 2-TC Results model in a Bland-Altman plot (Fig. 5) a large overesti- Radiosynthesis mation (38.8 ± 3.57%) of the BPND-values was found using [18F] altanserin was obtained after 70 min of synthesis the 1-TC model, which is clearly illustrated in Fig. 4. with end of synthesis (EOS) activities of 3.14 ± 1.16 GBq Moreover, a significant difference between de BPND-values Pauwelyn et al. BMC Veterinary Research (2019) 15:415 Page 3 of 11 Fig. 1 a: A Watabe function fitted to the mean fraction of intact [18F] altanserin (mean ± SD) in plasma over time for five dogs.
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