Teratoma formation can be a serious drawback after the therapeutic
transplantation of human embryonic stem (hES) cells. Therefore, noninvasive imaging of
teratomas could be a valuable tool for monitoring patients undergoing hES cell treatment. Here, we investigated the angiogenic process within
teratomas derived from hES cells and now report the first example of using (64)Cu-labeled RGD tetramer ((64)Cu-DOTA-RGD4) for positron emission tomography imaging of
teratoma formation by targeting alpha(v)
beta(3) integrin. H9 hES cells (2 x 10(6)), stably expressing
firefly luciferase, and enhanced green fluorescence
protein (Fluc-eGFP) were injected into adult nude mice (n=12) s.c. Eight weeks after
transplantation, these hES cell grafts evolved into
teratomas as confirmed by longitudinal bioluminescence imaging. Under micropositron emission tomography imaging, 2-deoxy-2-[(18)F]fluoro-
D-glucose and 3'-deoxy-3'-[(18)F]-fluorothymidine both failed to detect hES cell-derived
teratomas (0.8+/-0.5 versus 1.1+/-0.4 %ID/g, respectively; P=not significant versus background signals). By contrast, (64)Cu-DOTA-RGD4 revealed specific and prominent uptake in vascularized
teratoma and significantly lower uptake in control
tumors (human ovarian
carcinoma 2008 cell line), which had low
integrin expression (10.1+/-3.4 versus 1.4+/-1.2 %ID/g; P<0.01). Immunofluorescence staining of CD31 and
beta(3) integrin also supported our in vivo imaging results (P<0.05). Moreover, we found that the cells dissociated from
teratomas showed higher alpha(v)
beta(3) integrin expression than the 2008 cells. In conclusion, by targeting alpha(v)
beta(3) integrin, we successfully showed the ability of (64)Cu-DOTA-RGD4 to noninvasively visualize
teratoma formation in vivo for the first time.