Assessment of intra-arterial injected autologous bone marrow mononuclear cell distribution by radioactive labeling in acute ischemic stroke.
OBJECTIVE
To evaluate the feasibility of monitoring the autologous mononuclear bone marrow (ABMMN) cells implanted into the brain after acute ischemic stroke by the technique of labeling with Tc-99m-HMPAO.


METHODS
A 37-year-old man presented with aphasia, right-side hypoesthesia, and right homonymous hemianopsia after an acute ischemic stroke of the left middle cerebral artery. He was included in an autologous bone marrow mononuclear cell-based therapy research protocol about the safety of intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke. Nine days after the stroke he received 3.0 x 10(7) ABMMN cells delivered into the left cerebral middle artery via a balloon catheter. Approximately 1% of these cells were labeled with 150 MBq (4 mCi) Tc-99m by incubation with hexamethylpropylene amine oxime (HMPAO).


RESULTS
Brain perfusion images with Tc-99m ECD demonstrated hypoperfusion in the left temporal and parietal regions. The perfusion brain images were compared with tomographic views of the brain obtained 8 hours after ABMMN-labeled cell delivery, revealing intense accumulation of the ABMMN-labeled cells in the ipsilateral hemisphere. A whole-body scan was done and showed left brain, liver, and spleen uptake.


CONCLUSIONS
Our results showed that Tc-99m HMPAO can be used to label ABMMN cells for in vivo cell visualization, and that brain SPECT imaging with labeled ABMMN cells is a feasible noninvasive method for studying the fate of transplanted cells in vivo. Additionally, our findings demonstrate the localization of these intra-arterially injected cells.
Correa
Patricia Lavatori
PL
Hospital Procardiaco, Rio de Janeiro, Brazil. medicina.nuclear@procardiaco.com.br
Mesquita
Claudio T
CT
Felix
Renata M
RM
Azevedo
Jader C
JC
Barbirato
Gustavo B
GB
Falcão
Carlos Henrique
CH
Gonzalez
Constantino
C
Mendonça
Maria Lucia
ML
Manfrim
Aquiles
A
de Freitas
Gabriel
G
Oliveira
Cristina C
CC
Silva
Daniel
D
Avila
Dione
D
Borojevic
Radovan
R
Alves
Suzana
S
Oliveira
Amarino C
AC
Dohmann
Hans F
HF
D000328:Adult; D001854:Bone Marrow Cells / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000150:complications* / Q000000981:diagnostic imaging*; D038524:Diffusion Magnetic Resonance Imaging; D006801:Humans; D007269:Injections, Intra-Arterial; D007963:Leukocytes, Mononuclear / Q000000981:diagnostic imaging*; D008297:Male; D011877:Radionuclide Imaging; D020521:Stroke / Q000150:complications* / Q000000981:diagnostic imaging*; D014182:Transplantation, Autologous