Alison H Clifford, Jonathan Abele, Ryan Hung, Frank Wuest, Jan Andersson, Susan Pike, Elaine Yacyshyn, Eric Lenza, Glen Jickling, Paolo Raggi, Jan Willem Cohen Tervaert
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引用次数: 0
Abstract
Purpose: [18F]Fluorodeoxyglucose (FDG) is widely used in PET/CT imaging to detect large vessel vasculitis in giant cell arteritis (GCA), but its performance is suboptimal in patients receiving glucocorticoids. We aimed to compare [68Ga]Ga-HA-DOTA-TATE, a somatostatin 2-analogue tracer, to [18F]FDG in a pilot study of patients with GCA.
Methods: Eight patients with active GCA were prospectively, sequentially scanned with both [18F]FDG PET/CT and [68Ga]Ga-HA-DOTA-TATE PET/CT imaging. Images were evaluated by 2 blinded nuclear medicine specialists. Tracer uptake was assessed in 8 vascular territories using SUVmax, and target-background ratios (TBR) were calculated using both right atrium (TBRRA) and liver mean (TBRliver). Mean SUVmax and TBR of individual vascular territories and index vessels were compared.
Results: The patient median age was 71.5 years (range 64-82), and 4 (50%) were women. Active vasculitis (≥ grade 2 visual uptake in large vessels) was present in 62.5% of [18F]FDG scans. [18F]FDG scans had higher RA background activity than [68Ga]Ga-HA-DOTA-TATE (mean RA SUVmean 1.88 vs. 0.36, p < 0.001), while [68Ga]Ga-HA-DOTA-TATE had a significantly higher liver uptake (mean liver SUVmean 7.54 vs. 2.39, p < 0.001). Vascular uptake (as measured by both SUVmax and TBRliver) was significantly higher in [18F]FDG than [68Ga]Ga-HA-DOTA-TATE scans in every vascular territory (p < = 0.05 for all comparisons), including index vessels (SUVmax 4.04 vs. 1.91, p = 0.01, TBRliver 1.73 vs. 0.27, p < 0.001).
Conclusion: In this pilot study of patients with active GCA, the arterial uptake of [68Ga]Ga-HA-DOTA-TATE was lower and less conspicuous compared to [18F]FDG. While further evaluation in larger cohorts is needed, a clear advantage of [68Ga]Ga-HA-DOTA-TATE over [18F]FDG for detecting vascular inflammation in GCA was not identified. TRIAL REGISTRATION, CLINICALTRIALS.GOV: NCT03812302, registered 2019-01-18, URL: https://clinicaltrials.gov/search?cond=dotatate%20%26;term=giant%20cell%20arteritis .
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