Long-axial field-of-view PET/CT for the assessment of inflammation in calcified coronary artery plaques with [68 Ga]Ga-DOTA-TOC

• Published in: European journal of nuclear medicine and molecular imaging 2024-01, Vol.51 (2), p.422-433
• Main Authors: Mingels, Clemens, Sari, Hasan, Gözlügöl, Nasir, Bregenzer, Carola, Knappe, Luisa, Krieger, Korbinian, Afshar-Oromieh, Ali, Pyka, Thomas, Nardo, Lorenzo, Gräni, Christoph, Alberts, Ian, Rominger, Axel, Caobelli, Federico
• Format: Article
• Language: English
• Subjects: Arteries; Arteriosclerosis; Atherosclerosis; Calcification; Calcification (ectopic); Calcium; Cardiology; Cardiovascular diseases; Cerebral infarction; Computed tomography; Coronary artery; Coronary vessels; Coronary Vessels - diagnostic imaging; Humans; Imaging; Inflammation; Inflammation - diagnostic imaging; Macrophages; Medical imaging; Medicine; Medicine & Public Health; Myocardial infarction; Nuclear Medicine; Octreotide; Oncology; Organometallic Compounds; Original; Original Article; Orthopedics; Plaque, Atherosclerotic - diagnostic imaging; Plaques; Positron emission; Positron emission tomography; Positron Emission Tomography Computed Tomography - methods; Radiology; Retrospective Studies; Risk factors; Scanners; Somatostatin; Stroke; Veins & arteries; Visual field
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-023-06435-6

Purpose Inflamed, prone-to-rupture coronary plaques are an important cause of myocardial infarction and their early identification is crucial. Atherosclerotic plaques are characterized by overexpression of the type-2 somatostatin receptor (SST 2 ) in activated macrophages. SST 2 ligand imaging (e.g. with [ 68  Ga]Ga-DOTA-TOC) has shown promise in detecting and quantifying the inflammatory activity within atherosclerotic plaques. However, the sensitivity of standard axial field of view (SAFOV) PET scanners may be suboptimal for imaging coronary arteries. Long-axial field of view (LAFOV) PET/CT scanners may help overcome this limitation. We aim to assess the ability of [ 68  Ga]Ga-DOTA-TOC LAFOV-PET/CT in detecting calcified, SST 2 overexpressing coronary artery plaques. Methods In this retrospective study, 108 oncological patients underwent [ 68  Ga]Ga-DOTA-TOC PET/CT on a LAFOV system. [ 68  Ga]Ga-DOTA-TOC uptake and calcifications in the coronary arteries were evaluated visually and semi-quantitatively. Data on patients’ cardiac risk factors and coronary artery calcium score were also collected. Patients were followed up for 21.5 ± 3.4 months. Results A total of 66 patients (61.1%) presented with calcified coronary artery plaques. Of these, 32 patients had increased [ 68  Ga]Ga-DOTA-TOC uptake in at least one coronary vessel (TBR: 1.65 ± 0.53). Patients with single-vessel calcifications showed statistically significantly lower uptake (SUV max 1.10 ± 0.28) compared to patients with two- (SUV max 1.31 ± 0.29, p