Isn’t it sweet: FDG may have a rival

The name is fluorodeoxymannose (FDM) and it is giving FDG some competition in the realm of glucose analogue imaging of atherosclerosis, according to a report published Jan. 12 in Nature.

Jagat Narula, MD, PhD, principal investigator of the study and director of the Cardiovascular Imaging Program at Mount Sinai Hospital in New York, and colleagues evaluated FDM to see how it compared to the sweet standard. Results showed that FDM could have some advantages.

“Our pre-clinical testing shows that PET imaging with the radiotracer FDM may potentially offer a more targeted strategy to detect dangerous, high-risk plaques and inflammation that may be associated with serious cardiovascular events,” said Narula, in a release.  

FDM targets the immune response of hungry and metabolically hyperactive macrophages hard at work in the inflammation-dense lining of dangerously atherosclerotic artery walls. So far the two biomarkers are comparable, but FDM may take the lead eventually due to the fact that a specialized macrophage called M2 have high levels of mannose receptors, which are a chemical lock and key for FDM. M2 are abundant in atherosclerotic arterial lesions. The novel FDM tracer could have as much as a 25 percent more uptake by these M2 macrophages.

Almost no such uptake resulted in non-atherosclerotic arteries, presenting strong evidence that FDM has value as a potential biomarker for atherosclerosis imaging.

“We are excited about our possibly sweeter imaging breakthrough, but further research and clinical trial testing will need to confirm its potential advantage,” Narula noted.