Data from Mitochondrial Imaging Detects Early Cardiac Changes Following Cancer Immunotherapy
Year: 2026
Type: other
Abstract: Purpose: Advances in cancer therapy have improved survival but increased the risk of treatment-related cardiotoxicity, which remains difficult to detect early with existing biomarkers. [18F]F-AraG is a positron emission tomography (PET) tracer that targets cells with active mitochondrial biogenesis, including cardiomyocytes and activated T cells, and may enable concurrent assessment of cardiac involvement and therapy-associated immune activity. This study evaluated whether [18F]F-AraG PET can serve as an early imaging biomarker of cardiac effects across different cancer therapies. Experimental Design: Twenty-six healthy subjects underwent [18F]F-AraG PET to establish baseline myocardial uptake. Seven patients with stage III melanoma and 10 with advanced non–small cell lung cancer were imaged before and after immunotherapy. Myocardial uptake (SUVmax, SUVmean, and SUVtotal) was quantified in the left ventricle (LV) and right ventricle (RV), with LV regional uptake analyzed using a 17-segment model. Myocardial uptake was examined in relation to abnormal cardiac status in a subset of patients with available electrocardiogram (ECG) data. Associations between cardiac uptake, mitochondrial content, and PGC1α expression were evaluated. Results: Healthy myocardium demonstrated consistent and spatially uniform [18F]F-AraG uptake across age and sex, with higher uptake in the LV than in the RV. Conventional therapy was associated with increased global myocardial uptake, whereas immunotherapy was associated with additional heterogeneous and focal myocardial uptake. Altered myocardial uptake patterns were observed in patients with ECG abnormalities. Conclusions: [18F]F-AraG PET detects therapy-associated changes in myocardial tracer uptake following cancer treatment. These findings support its potential utility as a noninvasive imaging approach for the early evaluation of cardiac effects in patients receiving cancer therapies.
Authors: Hee-Don Chae, Uttam Shrestha, Millie Das, Minal S. Vasanawala, Deepti Behl, Diwakar Davar, Shyam Srinivas, A. Dimitrios Colevas, John B. Sunwoo, Niko Del Mar, Michele Pierini, Michele Guillen, Jose Garcia, Negar Omidvari, Nikhil Gupta, Hilda Cabrera, Joseph E. Blecha, Simon R. Cherry, Henry F. VanBrocklin, Robert R. Flavell, Javid Moslehi, Youngho Seo, Jelena Levi
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
OpenAlex ID: W7203475775