4.8 Article

Radionuclide-based molecular imaging allows CAR-T cellular visualization and therapeutic monitoring

Journal

THERANOSTICS
Volume 11, Issue 14, Pages 6800-6817

Publisher

IVYSPRING INT PUBL
DOI: 10.7150/thno.56989

Keywords

chimeric antigen receptor T cell; molecular imaging; side effects; therapeutic monitoring; direct labeling; reporter gene; endogenous cell

Funding

  1. National Natural Science Foundation of China [82030052, 81630049, 31570937]
  2. Open Program of Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province [HYX19026]

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CAR-T therapy shows promising results in hematological cancers, but faces challenges in solid tumors, requiring more precise monitoring and assessment methods like radionuclide-based molecular imaging.
Chimeric antigen receptor T cell (CAR-T) therapy is a new and effective form of adoptive cell therapy that is rapidly entering the mainstream for the treatment of CD19-positive hematological cancers because of its impressive effect and durable responses. Huge challenges remain in achieving similar success in patients with solid tumors. The current methods of monitoring CAR-T, including morphological imaging (CT and MRI), blood tests, and biopsy, have limitations to assess whether CAR-T cells are homing to tumor sites and infiltrating into tumor bed, or to assess the survival, proliferation, and persistence of CAR-T cells in solid tumors associated with an immunosuppressive microenvironment. Radionuclide-based molecular imaging affords improved CAR-T cellular visualization and therapeutic monitoring through either a direct cellular radiolabeling approach or a reporter gene imaging strategy, and endogenous cell imaging is beneficial to reflect functional information and immune status of T cells. Focusing on the dynamic monitoring and precise assessment of CAR-T therapy, this review summarizes the current applications of radionuclide-based noninvasive imaging in CAR-T cells visualization and monitoring and presents current challenges and strategic choices.

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