Juliet A. Wendt

Intensive Medical Therapy Versus Coronary Angioplasty for Suppression of Myocardial Ischemia in Survivors of Acute Myocardial Infarction A Prospective, Randomized Pilot Study

BACKGROUND Patients who have inducible ischemia after acute myocardial infarction (AMI) generally undergo coronary angiography with the intent to revascularize. Whether this approach is superior to intensive treatment with anti-ischemic medications is unknown. METHODS AND RESULTS We performed a prospective, randomized pilot study comparing intensive medical therapy with coronary angioplasty (PTCA) for suppression of myocardial ischemia in 44 stable survivors of AMI. Myocardial ischemia was quantified with adenosine 201Tl tomography (SPECT) performed 4.5+/-2.9 days after AMI. All patients at baseline had a large total (>/=20%) and ischemic (>/=10%) left ventricular perfusion defect size (PDS). SPECT was repeated at 43+/-26 days after therapy was optimized. The total stress-induced PDS was comparably reduced with medical therapy (from 38+/-13% to 26+/-16%; P<0.0001) and PTCA (from 35+/-12% to 20+/-16%; P<0.0001). The reduction in ischemic PDS was also similar (P=NS) in both groups. Cardiac events occurred in 7 of 44 patients over 12+/-5 months. Patients who remained clinically stable had a greater reduction in ischemic PDS (-13+/-9%) than those who had a recurrent cardiac event (-5+/-7%; P<0.02). Event-free survival was superior in the 24 patients who had a significant (>/=9%) reduction in PDS (96%) compared with those who did not (65%; P=0.009). CONCLUSIONS In this small pilot study, intensive medical therapy and PTCA were comparable at suppressing ischemia in stable patients after AMI. Sequential imaging with adenosine SPECT can track changes in PDS after anti-ischemic therapies and thereby predict subsequent outcome. Corroboration of these preliminary findings in a larger cardiac-event trial is warranted.

New Horizons for Imaging Lymphatic Function

In this review, we provide a comprehensive summary of noninvasive imaging modalities used clinically for the diagnosis of lymphatic diseases, new imaging agents for assessing lymphatic architecture and cancer status of lymph nodes, and emerging near‐infrared (NIR) fluorescent optical imaging technologies and agents for functional lymphatic imaging. Given the promise of NIR optical imaging, we provide example results of functional lymphatic imaging in mice, swine, and humans, showing the ability of this technology to quantify lymph velocity and frequencies of propulsion resulting from the contractility of lymphatic structures.

Multi-wavelength Optical Imaging of Human Tumour Xenografts

In vivo optical imaging methods have become a cornerstone of pre-clinical cancer research. Genetically modified cells with fluorescent or bioluminescent reporters allow researchers to non-invasively study tumour proliferation and biochemistry over time. Target-specific fluorescent probes may be used to reveal specific tumour properties such as growth patterns, neovasculature formation, and compartmental probe absorbance. Herein, we demonstrate the simultaneous optical imaging of these tumour properties in a human neuroblastoma model. We used luciferase-positive cancer cells, a neovasculature specific fluorescent probe, and a fluorescent tumour cell target-specific agent, in conjunction with X-ray/CT for anatomical localization. These experiments revealed a detailed map of the tumour progression and biological interactions with imaging agents within the tumour.

Abstract 4317: Developing near infrared (NIR) optical retinoid analogue for cancer imaging

Imaging technology plays an important role in early detection of cancers and improved prognoses. Among of the various imaging techniques used near infrared (NIR) optical imaging is an active and promising area for both in vitro and in vivo molecular imaging studies. However, NIR fluorophores normally only possess optical imaging properties without selectivity to diseased tissues. To address this problem, a targeting moiety can be introduced to help to deliver the imaging report to its target. It is know that retinoids, analogs of vitamin A, are assessed for multiple therapeutic uses. In practically, their potential chemopreventive and therapeutic roles in different kinds of cancers have attracted much attention. The cancer types include head and neck, lung, breast, esophagus, colon, kidney, prostate, bladder cancers and so on. Considering about important role of retinoids in cancer treatment developing retinoid derivatives as targeting imaging agents should be a useful strategy for noninvasive detection and characterization of solid tumors. Herein, we developed fluorescent retinoid derivatives for cancer imaging. Several different cancer cell lines and cancer xenograft models were used in this study. The data demonstrate that this new imaging agent can be used to imaging different kinds of cancers from cell level to whole body. Furthermore, these imaging agents have the potential to develop into special therapeutic agents that can be used for diagnosis, treatment and monitor of retinoid positive diseases. Note: This abstract was not presented at the AACR 101st Annual Meeting 2010 because the presenter was unable to attend. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the 101st Annual Meeting of the American Association for Cancer Research; 2010 Apr 17-21; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2010;70(8 Suppl):Abstract nr 4317.