A new bioorthogonal PET reporter gene for cardiac regenerative medicine binding to DTPA-lanthanide complexes

The lack of non-invasive, quantitative methods to track the location and proliferation of transplanted cells hampers the clinical translation of cardiac regenerative therapies. Here, we establish a PET reporter for tracking human induced pluripotent stem cell (hiPSC)-derived cardiac cells across complementary two-dimensional (2D) and three-dimensional (3D) cardiac tissue models. Methods hiPSCs were genetically engineered using CRISPR-Cas9 to express a human-derived, anticalin-based, bioorthogonal PET reporter (DTPA-R) that specifically binds radiolabeled DTPA-metal complexes. The engineered hiPSCs were differentiated into ventricular progenitors (HVPs) and cardiomyocytes (CMs). Stability of reporter gene expression and its effects on cellular differentiation and function were evaluated. Uptake of [18F]F-DTPA*Tb by DTPA-R-positive and -negative HVPs was analyzed in vitro, and DTPA-R HVPs were evaluated in ex vivo cultured porcine myocardial slices with and without radiofrequency ablation (RFA) injury. Phantom studies were performed to evaluate PET detectability under clinically relevant large-animal and human imaging conditions and to assess how activity distribution affects signal detection in relation to DTPA-R cardiac cell-equivalent numbers. Results DTPA-R expression was maintained during the differentiation stages of hiPSC-derived cardiac cells and had no measurable impact on migration, differentiation, and functional integration. PET imaging enabled the specific detection of DTPA-R HVPs in intact and injured myocardial slices. At the initial phantom scan, the measured activity corresponded to cell-equivalent numbers of approximately 3.2 x 10^6 HVPs or 5.5 x 10^6 CMs. The compact 200 uL source remained clearly detectable at 6 h, whereas the more dispersed 1,000 uL source progressively approached background activity, indicating that PET detectability depended strongly on local activity concentration and distribution. Conclusion This study establishes a bioorthogonal PET reporter gene platform for quantitative imaging of hiPSC-derived cardiac cells, with no measurable adverse effects on the biological parameters examined, and provides a methodological foundation for future translational and in vivo imaging studies. The approach may also be applicable to other hiPSC-derived cell products beyond cardiac cell lineages.