Subacute myocardial infarction detected by technetium-99m-labeled somatostatin analog scintigraphy

J Nucl Cardiol. 2022 Dec;29(6):3586-3589. doi: 10.1007/s12350-021-02644-4. Epub 2021 Apr 30.

Abstract

Recently, the applicability of somatostatin receptor-targeted (SSTR-t) radiotracers for post-ischemic myocardial inflammation imaging has been shown using PET. Currently, there are no studies which demonstrate ability of SPECT and technetium-99m SSTR-t radiotracers to detect inflammation, which appears in response to acute myocardial infarction (AMI). A case of 51-year-old male with acute anterior myocardial infarction (AMI) with ST elevation has been presented. This patient on 7th day after AMI onset underwent SPECT/CT (by cardiac cadmium-zinc-telluride gamma-camera) with 99mTc-Tectrotide, cardiac MRI with gadolinium and, on 9th day after AMI, myocardial perfusion scintigraphy (MPS) at rest. Clear myocardial uptake of 99mTc-Tectrotide, predominantly in apical and intermediate anterior wall of left ventricle was detected. The uptake matched with areas of hypoperfusion (by SPECT) and myocardial injury (by MRI). This case demonstrated the applicability of technetium-99m-labeled SSTR-t radiotracers for post-infarction inflammation imaging. Currently assumed, that SSTR-t radiotracers reflect an increased number of activated macrophages infiltrating infarcted myocardium, which is not possible using any other imaging technique. Thus, potentially, SSTR scintigraphy may be useful for diagnosis and monitoring of myocardial post-infarction inflammation as well as for anti-inflammatory image-guide therapy assessment.

Keywords: Inflammation; SPECT; hybrid imaging; myocardial ischemia and infarction; tests.

Publication types

  • Case Reports

MeSH terms

  • Humans
  • Inflammation
  • Male
  • Middle Aged
  • Myocardial Infarction* / diagnostic imaging
  • Myocarditis*
  • Radionuclide Imaging
  • Receptors, Somatostatin
  • Somatostatin
  • Technetium
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tomography, X-Ray Computed

Substances

  • Technetium
  • Somatostatin
  • Technetium Tc 99m Sestamibi
  • Receptors, Somatostatin