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PETCT Imaging of Unstable Carotid Plaque with Ga-68 labelled Somatostatin Receptor Ligand

Wan, MY; Endozo, R; Michopoulou, S; Shortman, R; Rodriguez-Justo, M; Menezes, L; Yusuf, S; ... Groves, A; + view all (2017) PETCT Imaging of Unstable Carotid Plaque with Ga-68 labelled Somatostatin Receptor Ligand. The Journal of Nuclear Medicine , 58 (5) pp. 774-780. 10.2967/jnumed.116.181438. Green open access

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Abstract

BACKGROUND: Ga68 labelled 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 Ga68-DOTATATE uptake in patients with recent carotid events, assessed inter- and intra- observer variability of such measurements, and explored the mechanism of any plaque DOTATATE activity with immunohistochemistry in resected specimens. MATERIALS & METHODS: 20 consecutively consenting patients with recent symptomatic carotid events (transient ischaemic attack [TIA], stroke or amaurosis fugax), due for carotid endarterectomy were prospectively recruited. Ga68-DOTATATE PET/CT of the neck was performed prior to surgery. Ga68-DOTATATE uptake was measured by drawing regions of interest (ROI) along the carotid plaques and contralateral plaques/carotid arteries by experienced radionuclide radiologist and radiographer. Two PET quantification methods with inter- and Intra-observer variability were assessed. Resected carotid plaques were retrieved for sst-2 immunohistochemical stain. RESULTS: Median time delay between research PET and surgery was 2days. SUV and TBR values for the symptomatic plaques and the asymptomatic contralateral carotid arteries/plaques show no significant difference (n = 19, p-value >0.10), regardless of quantification method. Intraclass correlation coefficient was >0.8 in all measures of carotid artery/plaque uptake (SUV) and >0.6 in almost all measures of target-to-background ratio (TBR). None of the excised plaques were shown to contain cells (macrophages, lymphocytes, vessel-associated cells) expressing sst2 on their cell membrane. CONCLUSION: Ga68 DOTATATE activity on PET in recently symptomatic carotid plaques is not significantly different to 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.

Type: Article
Title: PETCT Imaging of Unstable Carotid Plaque with Ga-68 labelled Somatostatin Receptor Ligand
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.2967/jnumed.116.181438
Publisher version: http://dx.doi.org/10.2967/jnumed.116.181438
Language: English
Additional information: This research was originally published in Wan, MY; Endozo, R; Michopoulou, S; Shortman, R; Rodriguez-Justo, M; Menezes, L; Yusuf, S; (2016) PETCT Imaging of Unstable Carotid Plaque with Ga-68 labelled Somatostatin Receptor Ligand. The Journal of Nuclear Medicine. Copyright © by the Society of Nuclear Medicine and Molecular Imaging, Inc.
Keywords: DOTATATE, Molecular Imaging, PET/CT, PETCT, Vascular, carotid, somatostatin, vulnerable plaques
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Pathology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Medicine > Department of Imaging
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > MRC Clinical Trials Unit at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/1534325
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