Potential clinical utility of 68Ga-DOTATATE PET/CT for detection and response assessment in cardiac sarcoidosis

被引:9
|
作者
Lee, Hwan [1 ]
Schubert, Erin K. [1 ]
Vidula, Mahesh K. [2 ]
Pryma, Daniel A. [1 ]
Marchlinski, Francis E. [2 ]
Goldberg, Lee R. [2 ]
Clancy, Caitlin B. [3 ]
Rossman, Milton D. [3 ]
DiCarli, Marcelo F. [4 ,5 ,6 ]
Bravo, Paco E. [1 ,2 ]
机构
[1] Hosp Univ Penn, Dept Radiol, Div Nucl Med Imaging & Therapy, 3400 Spruce St, Philadelphia, PA 19104 USA
[2] Hosp Univ Penn, Dept Med, Div Cardiovasc Med, Philadelphia, PA 19104 USA
[3] Hosp Univ Penn, Dept Med, Div Pulm Allergy & Crit Care, Philadelphia, PA 19104 USA
[4] Brigham & Womens Hosp, Dept Radiol, Div Nucl Med & Mol Imaging, 75 Francis St, Boston, MA 02115 USA
[5] Harvard Med Sch, Boston, MA 02115 USA
[6] Brigham & Womens Hosp, Dept Med, Div Cardiovasc Med, 75 Francis St, Boston, MA 02115 USA
关键词
Cardiac sarcoidosis; Ga-68-DOTATATE; F-18-FDG; positron emission tomography; response assessment; POSITRON-EMISSION-TOMOGRAPHY; MYOCARDIAL INFLAMMATION; PATIENT;
D O I
10.1007/s12350-022-03111-4
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background Somatostatin receptor is expressed in sarcoid granulomas, and preliminary clinical studies have shown that myocardial sarcoidosis can be identified on somatostatin receptor-targeted PET. We examined the potential clinical use of Ga-68-DOTATATE PET/CT for diagnosis and response assessment in cardiac sarcoidosis compared to F-18-FDG PET/CT. Methods Eleven cardiac sarcoidosis patients with F-18-FDG PET/CT were prospectively enrolled for cardiac Ga-68-DOTATATE PET/CT. The two PET/CT studies were interpreted independently and were compared for patient-level and segment-level concordance, as well as for the degree of radiotracer uptake. Follow-up Ga-68-DOTATATE PET/CT was performed in eight patients. Results Patient-level concordance was 91%: ten patients had multifocal DOTATATE uptake (active cardiac sarcoidosis) and one patient showed diffuse DOTATATE uptake. Segment-level agreement was 77.1% (Kappa 0.53 +/- 0.07). The SUVmax-to-blood pool ratio was lower on Ga-68-DOTATATE PET/CT (3.2 +/- 0.6 vs. 4.9 +/- 1.5, P = 0.006 on paired t test). Follow-up Ga-68-DOTATATE PET/CT showed one case of complete response and one case of partial response, while F-18-FDG PET/CT showed four cases of response, including three with complete response. Conclusion Compared to F-18-FDG PET/CT, Ga-68-DOTATATE PET/CT can identify active cardiac sarcoidosis with high patient-level concordance, but with moderate segment-level concordance, low signal-to-background ratio, and underestimation of treatment response.
引用
收藏
页码:1075 / 1087
页数:13
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