Clinical Translation of 18F-Labeled Hydroxyphenethylguanidines

University of Michigan

Status and phase: Completed; Early Phase 1

Conditions: Autonomic Peripheral Nervous System Diseases

Treatments: Drug: [18F]3F-PHPG; Drug: [18F]4F-MHPG

Study type: Interventional

Funder types: Other

Identifiers

NCT02385877

HUM00088601

Details and patient eligibility

About

The purpose of this study is to perform first-in-human PET imaging studies of two new cardiac sympathetic nerve imaging agents, 4-[18F]fluoro-meta-hydroxyphenethylguanidine ([18F]4F-MHPG) and 3-[18F]fluoro-para-hydroxyphenethylguanidine ([18F]3F-PHPG).

Full description

In this study, PET imaging studies of two structurally related 18F-hydroxyphenethylguanidines, 4-[18F]fluoro-meta-hydroxyphenethylguanidine ([18F]4F-MHPG) and 3-[18F]fluoro-para-hydroxyphenethylguanidine ([18F]3F-PHPG) will be performed. All studies will be performed in normal healthy volunteers.

PET stands for Positron Emission Tomography which is a type of imaging that uses a radioactive tracer. This is also called a radiotracer which is a compound linked to a radioactive element. Most compounds are short-lived, meaning that the radioactivity breaks down quickly or is excreted from the body.

In the first stage of the study, dynamic PET imaging for 90 min will be done with [18F]4F-MHPG (n = 4) and [18F]3F-PHPG (n = 4).

Data from these studies will assess each radiotracer's imaging properties, pharmacokinetics and metabolic breakdown in plasma. Application of tracer kinetic analysis methods to the kinetics of each tracer in heart and plasma will be studied to see if these methods can provide accurate measurements of regional nerve sympathetic nerve density in the hearts of human subjects. Results from these initial studies will be used to select the lead compound for further studies in patient populations.

In the second stage of the study, whole-body PET imaging studies (n = 4) with the selected lead radiotracer will be performed to acquire data necessary for generating more accurate human radiation absorbed dose estimates.

Enrollment: 16 patients

Sex: All

Ages: 18 to 55 years old

Volunteers: Accepts Healthy Volunteers

Inclusion criteria

• Non-obese (BMI < 30)
• Normal blood pressure
• Normal blood lipid profile
• No history of prior cardiovascular disease
• Not susceptible to claustrophobia
• Ability to lay flat for 90 min

Exclusion criteria

• Obesity (BMI > 30)
• Risk factors for heart disease (age > 55y, hypertension, smoking, high blood pressure, high cholesterol levels, diabetes, etc.)
• History of heart disease (heart attack, atrial fibrillation, ventricular tachycardia, exertional angina)
• Currently using certain medications that may interact with cardiac nerves (antidepressants, cold medications, nasal decongestants, monoamine oxidase inhibitors, etc.)
• Claustrophobia
• Inability to lie flat for 90 min
• Pregnant or breast feeding

Trial design

Primary purpose: Diagnostic

Allocation: Non-Randomized

Interventional model: Single Group Assignment

Masking: None (Open label)

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16 participants in 3 patient groups

Protocol 1: [18F]4F-MHPG

Experimental group

Description:

Subjects (n = 4) will be injected one time with 6.5 mCi of 4-\[18F\]fluoro-meta-hydroxyphenethylguanidine (\[18F\]4F-MHPG) and receive a 90 minute PET scan.

Treatment:

Drug: [18F]4F-MHPG

Protocol 1: [18F]3F-PHPG

Experimental group

Description:

Subjects (n = 4) will be injected one time with 6.5 mCi of 3-\[18F\]fluoro-para-hydroxyphenethylguanidine (\[18F\]3F-PHPG) and receive a 90 minute PET scan.

Treatment:

Drug: [18F]3F-PHPG

Protocol 2: Biodistribution Studies

Experimental group

Description:

Subjects (n = 4) will be injected one time with 6.5 mCi of either \[18F\]4F-MHPG or \[18F\]3F-PHPG (whichever is selected based on Protocol 1 studies) and receive four whole-body PET scans, starting at 5 min, 60 min, 150 min and 360 min after tracer injection.

Treatment:

Drug: [18F]3F-PHPG

Drug: [18F]4F-MHPG