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13.06.2019 | ORIGINAL ARTICLE

Feasibility of somatostatin receptor-targeted imaging for detection of myocardial inflammation: A pilot study

verfasst von: Paco E. Bravo, MD, Navkaranbir Bajaj, MD, MPH, Robert F. Padera, MD, PhD, Victoria Morgan, BS, Jon Hainer, BS, Courtney F. Bibbo, CNMT, Meagan Harrington, CNMT, Mi-Ae Park, PhD, Hyewon Hyun, MD, Matthew Robertson, MD, Neal K. Lakdawala, MD, John Groarke, MD, MPH, Garrick C. Stewart, MD, Sharmila Dorbala, MD, MPH, Ron Blankstein, MD, Marcelo F. Di Carli, MD

Erschienen in: Journal of Nuclear Cardiology | Ausgabe 3/2021

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Abstract

Background

Gallium-68 Dotatate binds preferentially to somatostatin receptor (sstr) subtype-2 (sstr-2) on inflammatory cells. We aimed at investigating the potential clinical use of sstr-targeted imaging for the detection of myocardial inflammation.

Methods

Thirteen patients, with suspected cardiac sarcoidosis (CS) based on clinical history and myocardial uptake on recent fluorine-18 fluorodeoxyglucose (FDG) PET, were enrolled to undergo Dotatate PET after FDG-PET (median time 37 days [IQR 25-55]). Additionally, we investigated ex-vivo the immunohistochemistry expression of sstr-2 in 3 explanted sarcoid hearts.

Results

All FDG scans showed cardiac uptake (focal/multifocal = 6, focal on diffuse/heterogeneous = 7), and 46% (n = 6) extra-cardiac uptake (mediastinal/hilar). In comparison, Dotatate scans showed definite abnormal cardiac uptake (focal/multifocal) in 4 patients, probably abnormal (heterogenous/patchy) in 3, and negative uptake in 6 cases. Similarly, 6 patients had increased mediastinal/hilar Dotatate uptake. Overall concordance of FDG and Dotatate uptake was 54% in the heart and 100% for thoracic nodal activity. Quantitatively, FDG maximum standardized uptake value was 5.0 times [3.8-7.1] higher in the heart, but only 2.25 times [1.7-3.0; P = .019] higher in thoracic nodes relative to Dotatate. Ex-vivo, sstr-2 immunostaining was weakly seen within well-formed granulomas in all 3 examined sarcoid heart specimens with no significant staining of background myocardium or normal myocardium.

Conclusion

Our preliminary data suggest that, compared to FDG imaging, somatostatin receptor-targeted imaging may be less sensitive for the detection of myocardial inflammation, but comparable for detecting extra-cardiac inflammation.

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Titel: Feasibility of somatostatin receptor-targeted imaging for detection of myocardial inflammation: A pilot study
verfasst von: Paco E. Bravo, MD
Navkaranbir Bajaj, MD, MPH
Robert F. Padera, MD, PhD
Victoria Morgan, BS
Jon Hainer, BS
Courtney F. Bibbo, CNMT
Meagan Harrington, CNMT
Mi-Ae Park, PhD
Hyewon Hyun, MD
Matthew Robertson, MD
Neal K. Lakdawala, MD
John Groarke, MD, MPH
Garrick C. Stewart, MD
Sharmila Dorbala, MD, MPH
Ron Blankstein, MD
Marcelo F. Di Carli, MD
Publikationsdatum: 13.06.2019
Verlag: Springer International Publishing
Erschienen in: Journal of Nuclear Cardiology / Ausgabe 3/2021
Print ISSN: 1071-3581
Elektronische ISSN: 1532-6551
DOI: https://doi.org/10.1007/s12350-019-01782-0

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Feasibility of somatostatin receptor-targeted imaging for detection of myocardial inflammation: A pilot study