rgd pet/ct imaging in covid-19 patients

Conditions: Covid19; Endothelial Dysfunction; PET Imaging

Summary: aim: we aim to evaluate αvβ3 integrin expression in proven covid-19 infected patients with indicative findings on routine contrast-enhanced ct using \[68ga\]ga-dota-(rgd)2. if activated vascular endothelium in the lung parenchyma proceeds ards, as frequently observed during covid-19 infection, imaging αvβ3 integrin expression using pet/ct could have potential as a clinical tool to characterize patients at early stages during disease and guide development of novel treatments targeting the vascular endothelium. study design: this is a prospective, observational non-randomized pilot study. maximum 10 patients will undergo a \[68ga\]ga-dota-(rgd)2 pet/ct scan and ct-subtraction scan in the same procedure. 10-minutes/bed position static \[68ga\]ga-dota-(rgd)2 pet/ct scans of the thorax will be acquired starting at 60 minutes post injection. study population: maximum 10 patients from the infectious diseases ward with proven covid-19 infection and indicative pulmonary abnormalities on contrast-enhanced ct (corads 4-5) undergo pet/ct scans after injection of 70 μg (200 mbq) \[68ga\]ga-dota-(rgd)2 and ct-subtraction. intervention: all patients will undergo a \[68ga\]ga-dota-(rgd)2 pet/ct scan, and in the same procedure, a ct-subtraction scan. primary study objective: the primary objective of this study is to demonstrate and quantitate activation of the endothelium in the lung vasculature using \[68ga\]ga-dota-(rgd)2 pet/ct. secondary study objectives: 1. to assess the spatial correlation between \[68ga\]ga-dota-(rgd)2 uptake and abnormal findings on routine contrast-enhanced ct scan of the chest 2. to assess the spatial correlation between \[68ga\]ga-dota-(rgd)2 and cts of the lung parenchyma 3. to assess the correlation between \[68ga\]ga-dota-(rgd)2 and laboratory results 4. to explore the correlation between \[68ga\]ga-dota-(rgd)2 uptake and clinical course of disease


Eligibility criteria:
inclusion criteria: * a microbiologically proven sars-cov-19 infection * pulmonary involvement as demonstrated on recent (\<1 week) chest ct, classified as corads 4 or 5, with indicative findings such as ill-demarcated multifocal ground glass opacities, mixed ground glass and consolidations, predominant peripheral and basal distribution, vascular thickening, round shaped and/or (reversed) halo * more than or equal to 18 years of age; * ability to provide written informed consent. exclusion criteria: • contra-indication for pet: pregnancy; breast-feeding; severe claustrophobia. * contra-indication for administration of iodine-containing contrast agents. * saturation \<94% at room air (without need of additional oxygen) * previously documented lung abnormalities that can interfere with interpretation of research scans, e.g. extensive fibrosis, known interstitial lung disease, pulmonary metastases, known pulmonary involvement of granulomatous diseases. * oth estimated creatinine clearance \< 30ml/min according to the cockcroft-gault formula (or local institutional standard method) or oligo-uric patients (\<400ml/24hr)

Keywords: covid-19 endothelial dysfunction pet imaging rgd-peptides