Assessment of Intra-arterial Injected Autologous Bone Marrow Mononuclear Cell Distribution by Radioactive Labeling in Acute Ischemic Stroke

• DOI: 10.1097/rlu.0b013e318156b980
• Publication Date: 2009-03-03T23:01:48Z
• Authors: Patricia Lavatori...; Claudio T. Mesquita; Renata M. Felix; Jader C. Azevedo; Gustavo B. Barbirato; Carlos Henrique F...; Constantino Gonzalez; Maria Lucia Mendonça; Aquiles Manfrim; Gabriel de Freitas; Cristina C. Oliveira; Daniel Silva; Dione Ávila; Radovan Borojevic; Suzana Alves; Amarino C. Oliveira; Hans F. Dohmann
• Keywords: Adult; Male; 0301 basic medicine; Bone Marrow Cells; Transplantation, Autologous; Brain Ischemia; 3. Good health; Stroke; 03 medical and health sciences; Diffusion Magnetic Resonance Imaging; 0302 clinical medicine; Injections, Intra-Arterial; Leukocytes, Mononuclear; Humans; Radionuclide Imaging

To evaluate the feasibility of monitoring the autologous mononuclear bone marrow (ABMMN) cells implanted into the brain after acute ischemic stroke by the technique of labeling with Tc-99m-HMPAO.A 37-year-old man presented with aphasia, right-side hypoesthesia, and right homonymous hemianopsia after an acute ischemic stroke of the left middle cerebral artery. He was included in an autologous bone marrow mononuclear cell-based therapy research protocol about the safety of intra-arterial autologous bone marrow mononuclear cell transplantation for acute ischemic stroke. Nine days after the stroke he received 3.0 x 10(7) ABMMN cells delivered into the left cerebral middle artery via a balloon catheter. Approximately 1% of these cells were labeled with 150 MBq (4 mCi) Tc-99m by incubation with hexamethylpropylene amine oxime (HMPAO).Brain perfusion images with Tc-99m ECD demonstrated hypoperfusion in the left temporal and parietal regions. The perfusion brain images were compared with tomographic views of the brain obtained 8 hours after ABMMN-labeled cell delivery, revealing intense accumulation of the ABMMN-labeled cells in the ipsilateral hemisphere. A whole-body scan was done and showed left brain, liver, and spleen uptake.Our results showed that Tc-99m HMPAO can be used to label ABMMN cells for in vivo cell visualization, and that brain SPECT imaging with labeled ABMMN cells is a feasible noninvasive method for studying the fate of transplanted cells in vivo. Additionally, our findings demonstrate the localization of these intra-arterially injected cells.