Detection of acute myocarditis by ECG-triggered PET imaging of somatostatin receptors compared to cardiac magnetic resonance: preliminary results

Somatostatin receptors are overexpressed by inflammatory cells but not by cardiac cells, under normal conditions. This study assesses the detection of acute myocarditis by the ECG-triggered digital-PET imaging of somatostatin receptors (68Ga-DOTATOC-PET), as compared to Cardiac Magnetic Resonance (C...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2023-06, Vol.30 (3), p.1043-1049
Main Authors: Boursier, Caroline, Chevalier, Elodie, Varlot, Jeanne, Filippetti, Laura, Huttin, Olivier, Roch, Véronique, Imbert, Laetitia, Albuisson, Eliane, Claudin, Marine, Mandry, Damien, Marie, Pierre-Yves
Format: Article
Language:English
Subjects:
68Ga-DOTATOC
cardiac MRI
Cardiology
digital-PET
Electrocardiography
Gallium Radioisotopes
Humans
Imaging
Magnetic Resonance Imaging - methods
Magnetic Resonance Spectroscopy
Medicine
Medicine & Public Health
Myocarditis
Nuclear Medicine
Organometallic Compounds
Original
Original Article
Positron-Emission Tomography - methods
Radiology
Receptors, Somatostatin
somatostatin receptor
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Summary:Somatostatin receptors are overexpressed by inflammatory cells but not by cardiac cells, under normal conditions. This study assesses the detection of acute myocarditis by the ECG-triggered digital-PET imaging of somatostatin receptors (68Ga-DOTATOC-PET), as compared to Cardiac Magnetic Resonance (CMR) imaging, which is the reference diagnostic method in this setting. Fourteen CMR-defined acute myocarditis patients had a first 15-minutes ECG-triggered 68Ga-DOTATOC PET recording, 4.4 ± 3.0 days from peak troponin, and 10 had a second 4.3 ± 0.3 months later. Myocardial/blood SUVmax ratio was analyzed relative to the normal upper limit of 2.18, which had been previously determined from oncology 68Ga-DOTATOC-PET recordings of patients with a similar age range as the myocarditis patients. An increased myocardial 68Ga-DOTATOC uptake relative to blood activity was invariably observed during the acute phase. SUVmax ratio exceeded 2.18 in all patients during the acute phase but also in 3/10 patients at 4-months, at a time when there were no more signs of active inflammation on CMR. A residual myocardial 68Ga-DOTATOC uptake was still observed on all gated-PET cine loops at 4-months. These preliminary results suggest that 68Ga-DOTATOC ECG-triggered digital-PET may be as sensitive as CMR at detecting myocarditis during the acute phase and more sensitive at later stages.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-022-03090-6