Detection of Atherosclerotic Inflammation by 68Ga-DOTATATE PET Compared to [18F]FDG PET Imaging
Jason M. Tarkin, Francis R. Joshi, Nicholas R. Evans, Mohammed M. Chowdhury, Nichola L. Figg, Aarti V. Shah, Lakshi T. Starks, Abel Martin-Garrido, Roido Manavaki, Emma Yu, Rhoda E. Kuc, Luigi Grassi, Roman Kreuzhuber, Myrto A. Kostadima, Mattia Frontini, Peter J. Kirkpatrick, Patrick A. Coughlin, Deepa Gopalan, Tim D. Fryer, John R. Buscombe, Ashley M. Groves, Willem H. Ouwehand, Martin R. Bennett, Elizabeth A. Warburton, Anthony P. Davenport and James H.F. Rudd
Comparison Between 68Ga-DOTATATE and [18F]FDG Coronary PET Inflammation Imaging
Images from a 57-year old man with acute coronary syndrome who presented with deep anterolateral T-wave inversion (arrow) on electrocardiogram (A) and serum troponin-I concentration elevated at 4,650 ng/l (NR: <17 ng/l). Culprit left anterior descending artery stenosis (dashed oval) was identified by X-ray angiography (B). After the patient underwent percutaneous coronary stenting (C), residual coronary plaque (*inset) with high-risk morphology (low attenuation and spotty calcification) is evident on CT angiography (D, E). Use of 68Ga-DOTATATE PET (F, H, I) clearly detected intense inflammation in this high-risk atherosclerotic plaque/distal portion of the stented culprit lesion (arrow) and recently infarcted myocardium (*). In contrast, using [18F]FDG PET (G, J), myocardial spillover completely obscures the coronary arteries. CT = computed tomography; [18F]FDG = fluorine-18-labeled fluorodeoxyglucose; 68Ga-DOTATATE = gallium-68-labeled DOTATATE; PET = positron emission tomography.