Abstract:Ga-DOTATOC uptake in the thoracic aorta exhibited a significant correlation with cardiovascular risk factors, which suggests the feasibility of Ga-DOTATOC PET for vulnerable plaque imaging, with a simple measurement of the single VOI method that is comparable to the multi-sample ROI-based approach.
“…In a study of 32 patients who underwent PET imaging with the TSPO radioligand 11 C-PK11195, culprit carotid plaques associated with stroke or transient ischaemic attack where highlighted by the tracer [10]. In this study, 11 C-PK11195 signals were F-FEDAA1106 [11] F-FEMPA [12] F-GE-180 [13] TSPO Activated macrophages Inflammatory cell recruitment/activity Ga-DOTATATE [14,18,19] Cu-DOTATATE [20,21] Ga-DOTANOC [18] F-FDR-NOC [18] Ga-DOTATOC [21,22] SST 2 F-flutemetamol [64] Amyloid n/a Amyloid within plaque confirmed in macrophage-rich plaque areas when examined histologically [10]. Other TSPO tracers that have potentially lower non-specific binding than 11 C-PK11195 and are less affected by genetic polymorphisms leading to variable receptor binding affinity are being investigated [11][12][13].…”
Section: Tracers For Imaging Inflammatory Cellsmentioning
confidence: 72%
“…Another study, of 64 Cu-DOTATATE, also found this tracer to be useful for identifying carotid artery inflammation in patients with transient ischaemic attack and identified an association with gene expression of markers in macrophages [ 20 ]. Several other clinical somatostatin receptor binding tracers have also been examined for use in atherosclerosis imaging [ 18 , 21 , 22 ]. Fig.…”
Section: Novel Pet Tracers For Imaging Atherosclerosismentioning
Purpose of Review
To provide a focused update on recent advances in positron emission tomography (PET) imaging in vascular inflammatory diseases and consider future directions in the field.
Recent Findings
While PET imaging with 18F-fluorodeoxyglucose (FDG) can provide a useful marker of disease activity in several vascular inflammatory diseases, including atherosclerosis and large-vessel vasculitis, this tracer lacks inflammatory cell specificity and is not a practical solution for imaging the coronary vasculature because of avid background myocardial signal. To overcome these limitations, research is ongoing to identify novel PET tracers that can more accurately track individual components of vascular immune responses. Use of these novel PET tracers could lead to a better understanding of underlying disease mechanisms and help inform the identification and stratification of patients for newly emerging immune-modulatory therapies.
Summary
Future research is needed to realise the true clinical translational value of PET imaging in vascular inflammatory diseases.
“…In a study of 32 patients who underwent PET imaging with the TSPO radioligand 11 C-PK11195, culprit carotid plaques associated with stroke or transient ischaemic attack where highlighted by the tracer [10]. In this study, 11 C-PK11195 signals were F-FEDAA1106 [11] F-FEMPA [12] F-GE-180 [13] TSPO Activated macrophages Inflammatory cell recruitment/activity Ga-DOTATATE [14,18,19] Cu-DOTATATE [20,21] Ga-DOTANOC [18] F-FDR-NOC [18] Ga-DOTATOC [21,22] SST 2 F-flutemetamol [64] Amyloid n/a Amyloid within plaque confirmed in macrophage-rich plaque areas when examined histologically [10]. Other TSPO tracers that have potentially lower non-specific binding than 11 C-PK11195 and are less affected by genetic polymorphisms leading to variable receptor binding affinity are being investigated [11][12][13].…”
Section: Tracers For Imaging Inflammatory Cellsmentioning
confidence: 72%
“…Another study, of 64 Cu-DOTATATE, also found this tracer to be useful for identifying carotid artery inflammation in patients with transient ischaemic attack and identified an association with gene expression of markers in macrophages [ 20 ]. Several other clinical somatostatin receptor binding tracers have also been examined for use in atherosclerosis imaging [ 18 , 21 , 22 ]. Fig.…”
Section: Novel Pet Tracers For Imaging Atherosclerosismentioning
Purpose of Review
To provide a focused update on recent advances in positron emission tomography (PET) imaging in vascular inflammatory diseases and consider future directions in the field.
Recent Findings
While PET imaging with 18F-fluorodeoxyglucose (FDG) can provide a useful marker of disease activity in several vascular inflammatory diseases, including atherosclerosis and large-vessel vasculitis, this tracer lacks inflammatory cell specificity and is not a practical solution for imaging the coronary vasculature because of avid background myocardial signal. To overcome these limitations, research is ongoing to identify novel PET tracers that can more accurately track individual components of vascular immune responses. Use of these novel PET tracers could lead to a better understanding of underlying disease mechanisms and help inform the identification and stratification of patients for newly emerging immune-modulatory therapies.
Summary
Future research is needed to realise the true clinical translational value of PET imaging in vascular inflammatory diseases.
“…Ga-68 DOTATATE does not demonstrate significant myocardial uptake, making it an excellent tracer for imaging of inflammation in coronary plaques. Using Ga-68 DOTATOC, Lee et al confirmed the correlation between arterial tracer uptake and patients' Framingham risk score (Lee et al 2018). Ga-68 has a longer positron range compared with F-18, hence PET imaging with Ga-68 suffers from a lower spatial resolution.…”
People living with human immunodeficiency virus (HIV) infection have twice the risk of atherosclerotic vascular disease compared with non-infected individuals. Inflammation plays a critical role in the development and progression of atherosclerotic vascular disease. Therapies targeting inflammation irrespective of serum lipid levels have been shown to be effective in preventing the occurrence of CVD. Radionuclide imaging is a viable method for evaluating arterial inflammation. This evaluation is useful in quantifying CVD risk and for assessing the effectiveness of anti-inflammatory treatment. The most tested radionuclide method for quantifying arterial inflammation among people living with HIV infection has been with F-18 FDG PET/CT. The level of arterial uptake of F-18 FDG correlates with vascular inflammation and with the risk of development and progression of atherosclerotic disease. Several limitations exist to the use of F-18 FDG for PET quantification of arterial inflammation. Many targets expressed on macrophage, a significant player in arterial inflammation, have the potential for use in evaluating arterial inflammation among people living with HIV infection. The review describes the clinical utility of F-18 FDG PET/CT in assessing arterial inflammation as a risk for atherosclerotic disease among people living with HIV infection. It also outlines potential newer probes that may quantify arterial inflammation in the HIV-infected population by targeting different proteins expressed on macrophages.
“…1 21 and summarized in the Table 1 . 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 In particular, we focus on Na[ 18 F]F PET/CT in the following section.…”
Section: Overview Of Molecular Imaging For Atherosclerosismentioning
Atherosclerosis is the leading cause of life-threatening morbidity and mortality, as the rupture of atherosclerotic plaques leads to critical atherothrombotic events such as myocardial infarction and ischemic stroke, which are the 2 most common causes of death worldwide. Vascular calcification is a complicated pathological process involved in atherosclerosis, and microcalcifications are presumed to increase the likelihood of plaque rupture. Despite many efforts to develop novel non-invasive diagnostic modalities, diagnostic techniques are still limited, especially before symptomatic presentation. From this point of view, vulnerable plaques are a direct target of atherosclerosis imaging. Anatomic imaging modalities have the limitation of only visualizing macroscopic structural changes, which occurs in later stages of disease, while molecular imaging modalities are able to detect microscopic processes and microcalcifications, which occur early in the disease process. Na[ 18 F]-fluoride positron emission tomography/computed tomography could allow the early detection of plaque instability, which is deemed to be a primary goal in the prevention of cardiac or brain ischemic events, by quantifying the microcalcifications within vulnerable plaques and evaluating the atherosclerotic disease burden.
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