68Ga-DOTATATE PET-CTA Imaging for the Early Detection of Progressing Coronary Atherosclerosis
Status:
Active, not recruiting
Trial end date:
2023-09-01
Target enrollment:
Participant gender:
Summary
68Ga-DOTATATE is a PET radiotracer with high affinity and selectivity for somatostatin
receptor 2 (SSTR 2) and is approved clinically for the evaluation of patients with
neuroendocrine tumors. The SSTR2 receptor is also highly expressed at the surface of human
macrophages and lymphocytes. In comparison to FDG, 68Ga-DOTATATE presents the advantage of
fast clearance from tissues, which are not expressing somatostatin receptors, in particular
muscular and myocardial tissues, and the level of blood glucose does not influence its
uptake.
Accumulation of 68Ga-DOTATATE has already been detected in coronary and carotid plaques and
is associated with the number of activated macrophages present in plaques obtained after
carotid endarterectomy. In a recent study, Tarkin et al. confirmed the preferential uptake of
68Ga-DOTATATE by macrophages in atherosclerotic plaques. In addition, the intensity of
68Ga-DOTATATE was higher in culprit lesions in the carotid and coronary arteries than in
stable lesions. The evaluation of 68Ga-DOTATATE uptake in coronary arteries was also strongly
facilitated in comparison to FDG thanks to the absence of spillover signal from the
myocardium.
AAA has developed a new kit that has markedly simplified the synthesis of 68Ga-DOTATATE and
has obtained in the US marketing authorization for the kit (Netspot; kit for the preparation
of Gallium-68-DOTATATE injection for intravenous use) on June 1st 2016 (NDA 208547) for
evaluation of patients with neuro-endocrine tumors. The Netspot kit will be used in this
study for the detection of progressing coronary atherosclerosis.