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Ultra-low-dose in vivo imaging in stem cell-enabled brain tumor theranostics using an optimized CZT-microSPECT scanner

Renu Rajamagesh, Elena Zannoni, Hannah J. Zhang, E. Markiewicz, Roberto Scarponi, Jacob R Pogue, Benedikt Haupt, Heejong Kim et al.

Medical Imaging, 2026

Abstract

Neural stem cells (NSCs) show significant therapeutic potential for targeted delivery of agents to brain tumors due to their intrinsic tropism and ability to cross the blood-brain barrier. However, the lack of a reliable, high-sensitivity method for non-invasive, in vivo NSC monitoring and tracking hinders the development of NSC-based therapies. We present the characterization, optimization and in vivo validation of the CZT-microSPECT system for high-sensitivity tracking of small populations of radiolabeled NSCs. The stationary CZT-microSPECT scanner, based on solid-state detectors and a custom-designed tungsten collimator, has been tested for imaging ultra-low activities of iodine-125 (125I; < 2.5 μCi) offering sub-keV energy resolution. Its unique design enables the system to act as 96 concurrent gamma cameras. We investigated the system’s high resolution and high sensitivity through Monte Carlo simulations and a preclinical longitudinal animal study. In the in vivo mouse study, the system successfully detected small clusters of radiolabeled NSCs with ultra-low injected activities (ranging between 0.6 and 2.56 μCi) in as little as 5 minutes imaging time. The system also captured the migration of NSCs from the injection site to distant metastatic locations. This work demonstrates the potential of ultra-low-dose SPECT imaging in developing and optimizing NSC-enabled theranostics of brain tumor.

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