Magnetic resonance mapping of transplanted endothelial progenitor cells for therapeutic neovascularization in ischemic heart disease

Objective: Intramyocardial transplantation of endothelial progenitor cells (EPCs) has been previously correlated with significant augmentation of vascularity and improvement of left ventricular function following myocardial ischemia. However, precise intramyocardial localization of the transplanted cells and the extent of in situ cell migration are unknown. We present a novel technique using magnetic resonance imaging (MRI) to localize transplanted EPCs in ischemic hearts. Methods: CD34-positive cells were isolated from human peripheral blood by magnetic bead selection: CD34-positive cells adhere to CD34-negative antibody coated magnetic beads, while CD34-negative cells do not. All cells were labeled with fluorescent DiI-dye for histological localization. CD34-positive cells or CD34-negative cells (105, 1×106 and 2×106 cells) were transplanted into non-ischemic (n=6) or ischemic myocardium (n=2) of Sprague-Dawley rats. Rats were sacrificed 24 h after cell transplantation. The resected hearts were imaged ex vivo using 3 and 8.5T magnets. Morphological correlation between the MRI findings and fluorescent microscopy for identification of retained CD34-positive cells was evaluated. Results: CD34-positive cells were identified as areas of low signal intensity on T2*-weighted images within the myocardium. These areas increased in size with the gradual increase in the echo time due to susceptibility effect. The extent of the low signal intensity at a given echo time was proportional to cell dosage. No areas of low signal were identified in the CD34-negative cell transplanted hearts. Histological localization of DiI-labeled CD34-positive cells documented a direct anatomic correlation with the localization of transplanted cells on the MRI images. Conclusions: Magnetically labeled EPCs transplanted for therapeutic neovascularization in myocardial ischemia can be visualized with ex vivo MRI at high-field strengths.