Central Illustration.

Comparison Between ⁶⁸Ga-DOTATATE and [¹⁸F]FDG Coronary PET Inflammation Imaging

Images from a 57-year old man with acute coronary syndrome who presented with deep anterolateral T-wave inversion (arrow) on electrocardiogram (A) and serum troponin-I concentration elevated at 4,650 ng/l (NR: <17 ng/l). Culprit left anterior descending artery stenosis (dashed oval) was identified by X-ray angiography (B). After the patient underwent percutaneous coronary stenting (C), residual coronary plaque (*inset) with high-risk morphology (low attenuation and spotty calcification) is evident on CT angiography (D, E). Use of ⁶⁸Ga-DOTATATE PET (F, H, I) clearly detected intense inflammation in this high-risk atherosclerotic plaque/distal portion of the stented culprit lesion (arrow) and recently infarcted myocardium (*). In contrast, using [¹⁸F]FDG PET (G, J), myocardial spillover completely obscures the coronary arteries. CT = computed tomography; [¹⁸F]FDG = fluorine-18-labeled fluorodeoxyglucose; ⁶⁸Ga-DOTATATE = gallium-68-labeled DOTATATE; PET = positron emission tomography.