Ultra-sensitive and multiplexed tracking of single cells using whole-body PET/CT

<p><em>In vivo </em>molecular imaging tools are crucially important for elucidating how cells move through complex biological systems, however, achieving single-cell sensitivity over the entire body remains challenging. Here, we report a highly sensitive and multiplexed approach for tracking upwards of 20 single cells simultaneously in the same subject using positron emission tomography (PET). The method relies on a statistical tracking algorithm (PEPT-EM) to achieve a sensitivity of 4 Bq/cell, and a streamlined workflow to reliably label single cells with over 50 Bq/cell of ¹⁸F-fluorodeoxyglucose (FDG). To demonstrate the potential of the method, we tracked the fate of over 70 melanoma cells after intracardiac injection and found they primarily arrested in the small capillaries of the pulmonary, musculoskeletal, and digestive organ systems. This study bolsters the evolving potential of PET in offering unmatched insights into the earliest phases of cell trafficking in physiological and pathological processes and in cell-based therapies.</p>