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      Radiopharmaceutical tracers for cardiac imaging

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          Abstract

          Cardiovascular disease (CVD) is the leading cause of death and disease burden worldwide. Nuclear myocardial perfusion imaging with either single-photon emission computed tomography or positron emission tomography has been used extensively to perform diagnosis, monitor therapies, and predict cardiovascular events. Several radiopharmaceutical tracers have recently been developed to evaluate CVD by targeting myocardial perfusion, metabolism, innervation, and inflammation. This article reviews old and newer used in nuclear cardiac imaging.

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          The online version of this article (10.1007/s12350-017-1131-5) contains supplementary material, which is available to authorized users.

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          ASNC imaging guidelines for SPECT nuclear cardiology procedures: Stress, protocols, and tracers.

          Hein J. Verberne, Milena J Henzlova, W Duvall … (2016)
          Article 0 comments Cited 126 times – based on 0 reviews     Review now
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            Detection of Atherosclerotic Inflammation by 68Ga-DOTATATE PET Compared to [18F]FDG PET Imaging

            Jason M Tarkin, Francis Joshi, Nicholas R. Evans … (2017)
            Background Inflammation drives atherosclerotic plaque rupture. Although inflammation can be measured using fluorine-18-labeled fluorodeoxyglucose positron emission tomography ([18F]FDG PET), [18F]FDG lacks cell specificity, and coronary imaging is unreliable because of myocardial spillover. Objectives This study tested the efficacy of gallium-68-labeled DOTATATE (68Ga-DOTATATE), a somatostatin receptor subtype-2 (SST2)-binding PET tracer, for imaging atherosclerotic inflammation. Methods We confirmed 68Ga-DOTATATE binding in macrophages and excised carotid plaques. 68Ga-DOTATATE PET imaging was compared to [18F]FDG PET imaging in 42 patients with atherosclerosis. Results Target SSTR2 gene expression occurred exclusively in “proinflammatory” M1 macrophages, specific 68Ga-DOTATATE ligand binding to SST2 receptors occurred in CD68-positive macrophage-rich carotid plaque regions, and carotid SSTR2 mRNA was highly correlated with in vivo 68Ga-DOTATATE PET signals (r = 0.89; 95% confidence interval [CI]: 0.28 to 0.99; p = 0.02). 68Ga-DOTATATE mean of maximum tissue-to-blood ratios (mTBRmax) correctly identified culprit versus nonculprit arteries in patients with acute coronary syndrome (median difference: 0.69; interquartile range [IQR]: 0.22 to 1.15; p = 0.008) and transient ischemic attack/stroke (median difference: 0.13; IQR: 0.07 to 0.32; p = 0.003). 68Ga-DOTATATE mTBRmax predicted high-risk coronary computed tomography features (receiver operating characteristics area under the curve [ROC AUC]: 0.86; 95% CI: 0.80 to 0.92; p < 0.0001), and correlated with Framingham risk score (r = 0.53; 95% CI: 0.32 to 0.69; p <0.0001) and [18F]FDG uptake (r = 0.73; 95% CI: 0.64 to 0.81; p < 0.0001). [18F]FDG mTBRmax differentiated culprit from nonculprit carotid lesions (median difference: 0.12; IQR: 0.0 to 0.23; p = 0.008) and high-risk from lower-risk coronary arteries (ROC AUC: 0.76; 95% CI: 0.62 to 0.91; p = 0.002); however, myocardial [18F]FDG spillover rendered coronary [18F]FDG scans uninterpretable in 27 patients (64%). Coronary 68Ga-DOTATATE PET scans were readable in all patients. Conclusions We validated 68Ga-DOTATATE PET as a novel marker of atherosclerotic inflammation and confirmed that 68Ga-DOTATATE offers superior coronary imaging, excellent macrophage specificity, and better power to discriminate high-risk versus low-risk coronary lesions than [18F]FDG. (Vascular Inflammation Imaging Using Somatostatin Receptor Positron Emission Tomography [VISION]; NCT02021188)
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              Radiation dose to patients from cardiac diagnostic imaging.

              R Thompson, Valíria D. Cerqueira, Hugo W Moser … (2007)
              Article 0 comments Cited 95 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Keiichiro Yoshinaga: 81 (43) 206 3429 , yoshinaga.keiichiro@qst.go.jp
                Journal
                Journal ID (nlm-ta): J Nucl Cardiol
                Journal ID (iso-abbrev): J Nucl Cardiol
                Title: Journal of Nuclear Cardiology
                Publisher: Springer US (New York )
                ISSN (Print): 1071-3581
                ISSN (Electronic): 1532-6551
                Publication date (Electronic): 1 December 2017
                Publication date PMC-release: 1 December 2017
                Publication date (Print): 2018
                Volume: 25
                Issue: 4
                Pages: 1204-1236
                Affiliations
                [1 ]ISNI 0000 0001 2173 7691, GRID grid.39158.36, Department of Nuclear Medicine, , Hokkaido University Graduate School of Medicine, ; Sapporo, Japan
                [2 ]ISNI 0000 0001 2181 8731, GRID grid.419638.1, Department of Radiopharmaceutical Development, National Institutes for Quantum and Radiological Science and Technology, , National Institute of Radiological Sciences, ; Chiba, Japan
                [3 ]ISNI 0000000089452978, GRID grid.10419.3d, Department of Cardiology, , Leiden University Medical Center, ; Leiden, The Netherlands
                [4 ]ISNI 0000 0001 2181 8731, GRID grid.419638.1, Diagnostic and Therapeutic Nuclear Medicine, National Institutes for Quantum and Radiological Science and Technology, , National Institute of Radiological Sciences, ; 4-9-1 Anagawa, Inage-Ku, Chiba, 263-8555 Japan
                Article
                Publisher ID: 1131
                DOI: 10.1007/s12350-017-1131-5
                PMC ID: 6133155
                PubMed ID: 29196910
                SO-VID: 833aa706-e64a-468d-8764-290c0c112a12
                Copyright © © The Author(s) 2017
                License:

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

                History
                Date received : 3 November 2017
                Date accepted : 5 November 2017
                Categories
                Subject: Review Article
                Custom metadata
                issue-copyright-statement © American Society of Nuclear Cardiology 2018

                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: cardiovascular disease,positron emission tomography,radiopharmaceutical,single-photon emission computed tomography
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine
                Keywords: cardiovascular disease, positron emission tomography, radiopharmaceutical, single-photon emission computed tomography

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