Potential utility of SPECT/CT with 99mTc-Tektrotyd for imaging of post-myocardial infarction inflammation

• Published in: Journal of nuclear cardiology 2023-12, Vol.30 (6), p.2544-2555
• Main Authors: Sazonova, Svetlana I., Ilyushenkova, Julia N., Syrkina, Anna G., Trusov, Andrey A., Mochula, Olga V., Mishkina, Anna I., Ryabov, Vyacheslav V.
• Format: Article
• Language: English
• Subjects: 99mTc-Tektrotyd; Cardiology; Heart; Heart attacks; Humans; Imaging; inflammation; Medicine; Medicine & Public Health; myocardial infarction; Myocardial Infarction - diagnostic imaging; Nuclear Medicine; Original Article; Radiology; Scintigraphy; Single Photon Emission Computed Tomography Computed Tomography; SPECT/CT; Technetium Tc 99m Sestamibi; Tomography, Emission-Computed, Single-Photon - methods; Tomography, X-Ray Computed
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-023-03312-5

There is a need to develop methods for post-myocardial infarction (MI) inflammation monitoring. Scintigraphy with somatostatin receptor targeted radiotracers has potential in this field. The purpose was to study the association of 99mTc-Tektrotyd uptake intensity in MI area with heart contractility indices over 6-month follow-up. Fourteen patients with acute ST-segment elevation anterior MI (STEMI) were examined with 99mTc-Tektrotyd SPECT/CT, myocardial perfusion scintigraphy (MPS) at rest, cardiac magnetic resonance imaging (cMRI) and transthoracic echocardiography (TTE). Scintigraphic results were compared with 6-month TTE indices. On the 7th day after a MI onset, cardiac 99mTc-Tektrotyd uptake was found in 7 of 14 patients. Median of 99mTc-Tektrotyd SUVmax was 1.59 (1.38; 2.83), the summed rest score (SRS) was 11 (5; 18), infarct size (by cMRI)—13.15 (3.3; 32.2) %. 99mTc-Tektrotyd SUVmax strongly correlated with 6-month heart contractility indices (r = 0.81, P < 0.05 for the end diastolic volume; r = 0.61 P < 0.05 for Δ end diastolic volume), with SRS (r = 0.85, P < 0.05) and infarct size (by cMRI) (r = 0.79, P < 0.05). The intensity (SUVmax) of 99mTc-Tektrotyd uptake in the area of recent MI directly depends on the size of ischemic myocardial injury and correlates with changes of heart contractility indexes over the 6 month follow-up.