title: Imaging Angiogenesis Using 99mTc-Macroaggregated Albumin Scintigraphy in Patients with Peripheral Artery Disease.
abstract: One problem of vascular angiogenesis therapy is the lack of reliable methods for evaluating blood flow in the microcirculation. We aimed to assess whether (99m)Tc-macroaggregated albumin perfusion scintigraphy ((99m)Tc-MAA) predicts quantitated blood flow after therapeutic angiogenesis in patients with peripheral artery disease.
  
  
  METHODS
  Forty-six patients with peripheral artery disease were treated with bone marrow mononuclear cell implantation (BMCI). Before and 4 wk after BMCI, blood flow was evaluated via transcutaneous oxygen tension (TcPO2), ankle-brachial index, intravenous (99m)Tc-tetrofosmin perfusion scintigraphy ((99m)Tc-TF), and intraaortic (99m)Tc-MAA.
  
  
  RESULTS
  Four weeks after BMCI, TcPO2 improved significantly (20.4 ± 14.4 to 36.0 ± 20.0 mm Hg, P < 0.01), but ankle-brachial index did not (0.65 ± 0.30 to 0.76 ± 0.24, P = 0.07). Improvement in (99m)Tc-TF count (0.60 ± 0.23 to 0.77 ± 0.29 count ratio/pixel, P < 0.01) and (99m)Tc-MAA count (5.21 ± 3.56 to 10.33 ± 7.18 count ratio/pixel, P = 0.02) was observed in the foot region but not the lower limb region, using both methods. When these data were normalized by subtracting the pixel count of the untreated side, the improvements in (99m)Tc-TF count (-0.04 ± 0.26 to 0.08 ± 0.32 count ratio/pixel, P = 0.04) and (99m)Tc-MAA count (1.49 ± 3.64 to 5.59 ± 4.84 count ratio/pixel, P = 0.03) in the foot remained significant. (99m)Tc-MAA indicated that the newly developed arteries were approximately 25 μm in diameter.
  
  
  CONCLUSIONS
  BMCI induced angiogenesis in the foot, which was detected using (99m)Tc-TF and (99m)Tc-MAA. (99m)Tc-MAA is a useful method to quantitate blood flow, estimate vascular size, and evaluate flow distribution after therapeutic angiogenesis.
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan gen52@nms.ac.jp.
authors.forename: Gen
authors.initials: G
authors.lastname: Takagi
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Miyamoto
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo, Japan.
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Fukushima
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yasutake
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Tara
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Ikuyo
authors.initials: I
authors.lastname: Takagi
authors.affiliation: FUJIFILM RI Pharma Co., Ltd., Tokyo, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Seki
authors.affiliation: Department of Radiology, Nippon Medical School, Tokyo, Japan.
authors.forename: Shinichiro
authors.initials: S
authors.lastname: Kumita
authors.affiliation: Department of Cardiovascular Medicine, Nippon Medical School, Tokyo, Japan.
authors.forename: Wataru
authors.initials: W
authors.lastname: Shimizu
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index; D001158:Arteries / Q000000981:diagnostic imaging / Q000254:growth & development; D001162:Arteriosclerosis Obliterans / Q000000981:diagnostic imaging / Q000628:therapy; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D005528:Foot / Q000000981:diagnostic imaging; D006801:Humans; D035002:Lower Extremity / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D010100:Oxygen / Q000097:blood; D010146:Pain / Q000209:etiology; D010147:Pain Measurement; D058729:Peripheral Arterial Disease / Q000150:complications / Q000000981:diagnostic imaging* / Q000628:therapy*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012039:Regional Blood Flow; D013668:Technetium Tc 99m Aggregated Albumin; D013919:Thromboangiitis Obliterans / Q000000981:diagnostic imaging / Q000628:therapy; D016896:Treatment Outcome
chemical_list: D009943:Organophosphorus Compounds; D015609:Organotechnetium Compounds; D019275:Radiopharmaceuticals; D013668:Technetium Tc 99m Aggregated Albumin; C078700:technetium tc-99m tetrofosmin; D010100:Oxygen
keywords: angiogenesis; bone marrow mononuclear cells; peripheral artery disease; radionuclide imaging; sensitivity and specificity