Potential utility of SPECT/CT with 99mTc-Tektrotyd for imaging of post-myocardial infarction inflammation

J Nucl Cardiol. 2023 Dec;30(6):2544-2555. doi: 10.1007/s12350-023-03312-5. Epub 2023 Jun 14.

Abstract

Background: There is a need to develop methods for post-myocardial infarction (MI) inflammation monitoring. Scintigraphy with somatostatin receptor targeted radiotracers has potential in this field. The purpose was to study the association of 99mTc-Tektrotyd uptake intensity in MI area with heart contractility indices over 6-month follow-up.

Methods: Fourteen patients with acute ST-segment elevation anterior MI (STEMI) were examined with 99mTc-Tektrotyd SPECT/CT, myocardial perfusion scintigraphy (MPS) at rest, cardiac magnetic resonance imaging (cMRI) and transthoracic echocardiography (TTE). Scintigraphic results were compared with 6-month TTE indices.

Results: On the 7th day after a MI onset, cardiac 99mTc-Tektrotyd uptake was found in 7 of 14 patients. Median of 99mTc-Tektrotyd SUVmax was 1.59 (1.38; 2.83), the summed rest score (SRS) was 11 (5; 18), infarct size (by cMRI)-13.15 (3.3; 32.2) %. 99mTc-Tektrotyd SUVmax strongly correlated with 6-month heart contractility indices (r = 0.81, P < 0.05 for the end diastolic volume; r = 0.61 P < 0.05 for Δ end diastolic volume), with SRS (r = 0.85, P < 0.05) and infarct size (by cMRI) (r = 0.79, P < 0.05).

Conclusion: The intensity (SUVmax) of 99mTc-Tektrotyd uptake in the area of recent MI directly depends on the size of ischemic myocardial injury and correlates with changes of heart contractility indexes over the 6 month follow-up.

Keywords: 99mTc-Tektrotyd; SPECT/CT; inflammation; myocardial infarction.

MeSH terms

  • Heart
  • Humans
  • Myocardial Infarction* / diagnostic imaging
  • Single Photon Emission Computed Tomography Computed Tomography
  • Technetium Tc 99m Sestamibi
  • Tomography, Emission-Computed, Single-Photon / methods
  • Tomography, X-Ray Computed*

Substances

  • technetium Tc 99m hydrazinonicotinyl-Tyr(3)-octreotide
  • Technetium Tc 99m Sestamibi