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Review
. 2021 Nov 25;10(23):5515.
doi: 10.3390/jcm10235515.

Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR)

Luz Kelly Anzola  1   2   3 , Jose Nelson Rivera  4 , Juan Carlos Ramirez  3 , Alberto Signore  5 , Fernando Mut  6
Affiliations
Review

Molecular Imaging of Vulnerable Coronary Plaque with Radiolabeled Somatostatin Receptors (SSTR)

Luz Kelly Anzola et al. J Clin Med. .

Abstract

Atherosclerosis is responsible for the majority of heart attacks and is characterized by several modifications of the arterial wall including an inflammatory reaction. The silent course of atherosclerosis has made it necessary to develop predictors of disease complications before symptomatic lesions occur. Vulnerable to rupture atherosclerotic plaques are the target for molecular imaging. To this aim, different radiopharmaceuticals for PET/CT have emerged for the identification of high-risk plaques, with high specificity for the identification of the cellular components and pathophysiological status of plaques. By targeting specific receptors on activated macrophages in high-risk plaques, radiolabelled somatostatin analogues such as 68Ga-DOTA-TOC, TATE,0 or NOC have shown high relevance to detect vulnerable, atherosclerotic plaques. This PET radiopharmaceutical has been tested in several pre-clinical and clinical studies, as reviewed here, showing an important correlation with other risk factors.

Keywords: 68Ga-DOTA-TATE; PET/CT; activated macrophages; atherosclerosis; vascular inflammation.

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Conflict of interest statement

The authors declare that they have no conflict of interest.

Figures

Figure 1
Figure 1
Pathogenesis mechanism and molecular imaging targets in vulnerable plaque. Schematic representation of event cascade leading to plaque inception and destabilization, and specific radiotracers to detect different events (inflammation by activated macrophages, apoptosis, neoangiogenesis, and calcification). Reprinted with permission from ref. [36].
Figure 2
Figure 2
Comparison between 68Ga-DOTATATE and 18F FDG. Culprit left anterior descending (LAD) coronary artery stenosis in a 57-year-old man with acute coronary syndrome. (A) ECG showing ST-T segment elevation and inverted deep T-waves in V2-V5. (B) Angiography detected severe obstructive LAD lesion. After percutaneous coronary stenting, residual coronary plaque is seen with low attenuation and spotty calcification (C–E; star symbol depicts location of residual lesion). 68Ga-DOTA-TATE PET shows intense focal uptake, consistent with inflammation of high-risk atherosclerotic plaques in the distal portion of the stented culprit lesion (F,H,I). 18F-FDG PET (G,J) shows myocardial spillover, completely obscuring the coronary arteries. Adapted with permission from ref. [20].
See this image and copyright information in PMC

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