“…This observation is consistent with the tracer's biodistribution that can be deduced from its binding profile: as the SSTR is overexpressed on activated macrophages, lymphocytes, and epithelioid cells, specific SSTR‐targeted radiotracers like 68 Ga‐DOTATOC may directly display their distribution and thereby identify sites of inflammation 10, 35. By contrast, LGE primarily depicts myocardial scar; given the aforesaid biodistribution of 68 Ga‐DOTATOC, PET/CT presently failed at imaging CMR‐detected LGE.…”
Section: Discussionsupporting
confidence: 83%
“…Among these, gallium scintigraphy and 18 F‐FDG PET/CT represent the best‐studied techniques, with the latter offering a higher sensitivity than single photon‐emitting procedures 29. SSTR‐directed PET/CT has been demonstrated to be feasible for imaging atherosclerotic and myocardial inflammatory processes 10, 30. The potential of SSTR‐directed PET/CT in the field of granulomatous diseases has foremost been described for 111 In‐labelled octreotide 31…”
Section: Discussionmentioning
confidence: 99%
“…granuloma epithelioid cells, macrophages, and giant cells. SSTR‐directed positron emission tomography (PET) imaging might complement CMR by visualizing the aforementioned inflammatory cell's distribution within damaged myocardium 10. In a sub‐analysis, we, therefore, retrospectively identified patients who additionally underwent PET/computed tomography (CT) using the SSTR ligand 68 Ga‐DOTA‐ d ‐Phe 1 ‐Tyr 3 ‐octreotide ( 68 Ga‐DOTATOC) and correlated PET results with CMR findings and clinical parameters.…”
AimsCardiac affection constitutes a major limiting condition in systemic sarcoidosis. The primary objective of this study was to investigate the persistence rate of cardiac sarcoid involvement by cardiovascular magnetic resonance (CMR) imaging in patients diagnosed with cardiac sarcoidosis (CS). Moreover, we examined the additional insights into myocardial damage's characteristics gained by somatostatin receptor scintigraphy.Methods and resultsIn a pilot study, we had previously identified cardiac involvement—diagnosed by CMR imaging—to be present in 29 of 188 patients (15.4%) with histologically proven, extra‐CS. Out of these initial 29 CS‐positive patients, 27 patients (49.9 ± 11.8 years, 59.3% male) were presently re‐examined and underwent a second CMR study and complementary standard clinical testing. Somatostatin receptor scintigraphy using the ligand 68Ga‐DOTATOC was additionally performed when clinically indicated (17 patients). Within a median follow‐up period of 2.6 years, none of the initial 29 patients deceased or experienced aborted sudden cardiac death. However, two patients developed third‐degree atrioventricular block that required device therapy. Among the 27 re‐examined CS patients, pathological CMR findings persisted in 14 of 27 patients (51.9%). CS remission was primarily due to a resolution of acute inflammatory processes. 68Ga‐DOTATOC positron emission tomography/computed tomography (PET/CT) identified one patient with regions of raised tracer uptake that concorded with acute inflammatory changes, as assessed by CMR; this patient received no immunosuppressive medication at the time of PET/CT execution.ConclusionsWithin follow‐up, CS persisted in barely half the patients, and the patients were not afflicted with cardiac death. Additional 68Ga‐DOTATOC PET/CT allowed for visualization of acute myocardial inflammation.
“…This observation is consistent with the tracer's biodistribution that can be deduced from its binding profile: as the SSTR is overexpressed on activated macrophages, lymphocytes, and epithelioid cells, specific SSTR‐targeted radiotracers like 68 Ga‐DOTATOC may directly display their distribution and thereby identify sites of inflammation 10, 35. By contrast, LGE primarily depicts myocardial scar; given the aforesaid biodistribution of 68 Ga‐DOTATOC, PET/CT presently failed at imaging CMR‐detected LGE.…”
Section: Discussionsupporting
confidence: 83%
“…Among these, gallium scintigraphy and 18 F‐FDG PET/CT represent the best‐studied techniques, with the latter offering a higher sensitivity than single photon‐emitting procedures 29. SSTR‐directed PET/CT has been demonstrated to be feasible for imaging atherosclerotic and myocardial inflammatory processes 10, 30. The potential of SSTR‐directed PET/CT in the field of granulomatous diseases has foremost been described for 111 In‐labelled octreotide 31…”
Section: Discussionmentioning
confidence: 99%
“…granuloma epithelioid cells, macrophages, and giant cells. SSTR‐directed positron emission tomography (PET) imaging might complement CMR by visualizing the aforementioned inflammatory cell's distribution within damaged myocardium 10. In a sub‐analysis, we, therefore, retrospectively identified patients who additionally underwent PET/computed tomography (CT) using the SSTR ligand 68 Ga‐DOTA‐ d ‐Phe 1 ‐Tyr 3 ‐octreotide ( 68 Ga‐DOTATOC) and correlated PET results with CMR findings and clinical parameters.…”
AimsCardiac affection constitutes a major limiting condition in systemic sarcoidosis. The primary objective of this study was to investigate the persistence rate of cardiac sarcoid involvement by cardiovascular magnetic resonance (CMR) imaging in patients diagnosed with cardiac sarcoidosis (CS). Moreover, we examined the additional insights into myocardial damage's characteristics gained by somatostatin receptor scintigraphy.Methods and resultsIn a pilot study, we had previously identified cardiac involvement—diagnosed by CMR imaging—to be present in 29 of 188 patients (15.4%) with histologically proven, extra‐CS. Out of these initial 29 CS‐positive patients, 27 patients (49.9 ± 11.8 years, 59.3% male) were presently re‐examined and underwent a second CMR study and complementary standard clinical testing. Somatostatin receptor scintigraphy using the ligand 68Ga‐DOTATOC was additionally performed when clinically indicated (17 patients). Within a median follow‐up period of 2.6 years, none of the initial 29 patients deceased or experienced aborted sudden cardiac death. However, two patients developed third‐degree atrioventricular block that required device therapy. Among the 27 re‐examined CS patients, pathological CMR findings persisted in 14 of 27 patients (51.9%). CS remission was primarily due to a resolution of acute inflammatory processes. 68Ga‐DOTATOC positron emission tomography/computed tomography (PET/CT) identified one patient with regions of raised tracer uptake that concorded with acute inflammatory changes, as assessed by CMR; this patient received no immunosuppressive medication at the time of PET/CT execution.ConclusionsWithin follow‐up, CS persisted in barely half the patients, and the patients were not afflicted with cardiac death. Additional 68Ga‐DOTATOC PET/CT allowed for visualization of acute myocardial inflammation.
“…Since activated macrophages overexpress somatostatin receptors on the cell surface, the suitability of PET imaging of inflammatory activity using [ 68 Ga]-labeled somatostatin analogs like [ 68 Ga]-DOTA-TATE or [ 68 Ga]-DOTA-TOC has been investigated in a small clinical pilot trial. In comparison to CMR, somatostatin receptor-directed imaging showed a close spatial relation of macrophage concentration to CMR-detected structural changes and might therefore serve as a more specific marker of macrophage activity [20]. However, pre-clinical experiments in mice questioned the usefulness of this approach [21].…”
Section: Myocardial Infarctionmentioning
confidence: 99%
“…4; [92]). Another new approach needing further evaluation includes targeting of somatostatin receptor 2 and has yielded encouraging results in a clinical pilot study [20]. Fig.…”
Purpose of ReviewInflammation is a key player in a wide range of cardiovascular and myocardial diseases. Given the numerous implications of inflammatory processes in disease initiation and progression, functional imaging modalities including positron emission tomography (PET) represent valuable diagnostic, prognostic, and monitoring tools in patient management. Since increased glucose metabolism is a hallmark of inflammation, PET using the radiolabeled glucose analog [18F]-2-deoxy-2-fluoro-d-glucose (FDG) is the mainstay diagnostic test for nuclear imaging of (cardiac) inflammation. Recently, new approaches using more specific tracers to overcome the limited specificity of FDG have emerged.Recent FindingsPET imaging has proven its value in a number of inflammatory conditions of the heart including myocarditis, endocarditis, sarcoidosis, or reactive changes after myocardial infarction. In infection-related endocarditis, FDG-PET and white blood cell scintigraphy have been implemented in current guidelines. FDG-PET is considered as nuclear medical gold standard in myocarditis, pericarditis, or sarcoidosis. Novel strategies, including targeting of somatostatin receptors or C-X-C motif chemokine receptor CXCR4, have shown promising results in first studies.SummaryNuclear medicine techniques offer valuable information in the assessment of myocardial inflammation. Given the possibility to directly visualize inflammatory activity, they represent useful tools for diagnosis, risk stratification, and therapy monitoring.
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