Ming Young Simon Wan1, Raymond Endozo2, Sofia Michopoulou2, Robert Shortman2, Manuel Rodriguez-Justo3, Leon Menezes2, Syed Yusuf4, Toby Richards5, Damian Wild6, Beatrice Waser7, Jean Claude Reubi7, Ashley Groves2. 1. Institute of Nuclear Medicine, University College London, London, United Kingdom mwan@nhs.net. 2. Institute of Nuclear Medicine, University College London, London, United Kingdom. 3. Department of Histopathology, University College London, London, United Kingdom. 4. Department of Vascular Surgery, Brighton and Sussex University Hospitals, Sussex, United Kingdom. 5. Department of Vascular Surgery, University College London, London, United Kingdom. 6. Division of Nuclear Medicine, University of Basel Hospital, Basel, Switzerland; and. 7. Cell Biology and Experimental Cancer Research, Institute of Pathology, University of Berne, Berne, Switzerland.
Abstract
68Ga-labeled somatostatin receptor ligand PET imaging has recently been shown in preclinical and early human studies to have a potential role in the evaluation of vulnerable arterial plaques. We prospectively evaluated carotid plaque 68Ga-DOTATATE uptake in patients with recent carotid events, assessed inter- and intraobserver variability of such measurements, and explored the mechanism of any plaque DOTATATE activity with immunohistochemistry in resected specimens. Methods: Twenty consecutively consenting patients with recent symptomatic carotid events (transient ischemic attack, stroke, or amaurosis fugax), due for carotid endarterectomy, were prospectively recruited. 68Ga-DOTATATE PET/CT of the neck was performed before surgery. 68Ga-DOTATATE uptake was measured by drawing regions of interest along the carotid plaques and contralateral plaques/carotid arteries by an experienced radionuclide radiologist and radiographer. Two PET quantification methods with inter- and intraobserver variability were assessed. Resected carotid plaques were retrieved for somatostatin receptor subtype-2 (sst2) immunohistochemical staining. Results: The median time delay between research PET and surgery was 2 d. SUVs and target-to-background ratios for the symptomatic plaques and the asymptomatic contralateral carotid arteries/plaques showed no significant difference (n = 19, P > 0.10), regardless of quantification method. The intraclass correlation coefficient was greater than 0.8 in all measures of carotid artery/plaque uptake (SUV) and greater than 0.6 in almost all measures of target-to-background ratio. None of the excised plaques was shown to contain cells (macrophages, lymphocytes, vessel-associated cells) expressing sst2 on their cell membrane. Conclusion: 68Ga-DOTATATE activity on PET in recently symptomatic carotid plaques is not significantly different from contralateral carotids/plaques. Any activity seen on PET is not shown to be from specific sst2 receptor-mediated uptake in vitro. It is therefore unlikely that sst2 PET/CT imaging will have a role in the detection and characterization of symptomatic carotid plaques.
68Ga-labeled somatostatin receptor ligand PET imaging has recently been shown in preclinical and early human studies to have a potential role in the evaluation of vulnerable arterial plaques. We prospectively evaluated carotid plaque 68Ga-DOTATATE uptake in patients with recent carotid events, assessed inter- and intraobserver variability of such measurements, and explored the mechanism of any plaque DOTATATE activity with immunohistochemistry in resected specimens. Methods: Twenty consecutively consenting patients with recent symptomatic carotid events (transient ischemic attack, stroke, or amaurosis fugax), due for carotid endarterectomy, were prospectively recruited. 68Ga-DOTATATE PET/CT of the neck was performed before surgery. 68Ga-DOTATATE uptake was measured by drawing regions of interest along the carotid plaques and contralateral plaques/carotid arteries by an experienced radionuclide radiologist and radiographer. Two PET quantification methods with inter- and intraobserver variability were assessed. Resected carotid plaques were retrieved for somatostatin receptor subtype-2 (sst2) immunohistochemical staining. Results: The median time delay between research PET and surgery was 2 d. SUVs and target-to-background ratios for the symptomatic plaques and the asymptomatic contralateral carotid arteries/plaques showed no significant difference (n = 19, P > 0.10), regardless of quantification method. The intraclass correlation coefficient was greater than 0.8 in all measures of carotid artery/plaque uptake (SUV) and greater than 0.6 in almost all measures of target-to-background ratio. None of the excised plaques was shown to contain cells (macrophages, lymphocytes, vessel-associated cells) expressing sst2 on their cell membrane. Conclusion: 68Ga-DOTATATE activity on PET in recently symptomatic carotid plaques is not significantly different from contralateral carotids/plaques. Any activity seen on PET is not shown to be from specific sst2 receptor-mediated uptake in vitro. It is therefore unlikely that sst2 PET/CT imaging will have a role in the detection and characterization of symptomatic carotid plaques.
Authors: Luz Kelly Anzola; Andor W J M Glaudemans; Rudi A J O Dierckx; F Andres Martinez; Sergio Moreno; Alberto Signore Journal: Eur J Nucl Med Mol Imaging Date: 2019-08-28 Impact factor: 9.236
Authors: Eric J Meester; Erik de Blois; Boudewijn J Krenning; Antonius F W van der Steen; Jeff P Norenberg; Kim van Gaalen; Monique R Bernsen; Marion de Jong; Kim van der Heiden Journal: EJNMMI Res Date: 2021-03-17 Impact factor: 3.138
Authors: Luz Kelly Anzola; Jose Nelson Rivera; Juan Carlos Ramirez; Alberto Signore; Fernando Mut Journal: J Clin Med Date: 2021-11-25 Impact factor: 4.241
Authors: Hilary E Barrett; Eric J Meester; Kim van Gaalen; Kim van der Heiden; Boudewijn J Krenning; Freek J Beekman; Erik de Blois; Jan de Swart; H J Verhagen; Theodosia Maina; Berthold A Nock; Jeffrey P Norenberg; Marion de Jong; Frank J H Gijsen; Monique R Bernsen Journal: Eur J Nucl Med Mol Imaging Date: 2020-04-15 Impact factor: 9.236
Authors: Monique R Bernsen; Kim van der Heiden; Eric J Meester; Boudewijn J Krenning; Erik de Blois; Marion de Jong; Antonius F W van der Steen Journal: J Nucl Cardiol Date: 2020-02-05 Impact factor: 3.872