Table 5.
Inflammation and atherosclerosis imaging
| Isotope | Radiopharmaceutical | Type of tracer | Study population | Characteristics | Approval year | |||
|---|---|---|---|---|---|---|---|---|
| FDA | Europe | Japan | ||||||
| General inflammation | ||||||||
| 18F | 18F-FDG |
|
Organic compound | Carotid and coronary plaque imaging Cardiac sarcoidosis Device infection |
Accumulating macrophage Strong signal Limitation: non-specific myocardial accumulation |
– | 1994* | 2012 (cardiac sarcoidosis) |
| 67Ga | 67Gallium | 67Ga3+ | Metal cation | Inflammatory heart disease Cardiac sarcoidosis |
No physiological uptake Limitation: suboptimal image quality |
1976 | 1972* | 1982 |
| Infection | ||||||||
| 111In | 111In WBC | Radiolabeled cell | Infectious disease | Accumulates in WBC Limitation: suboptimal image quality |
1985 | 1980** | 1992 | |
| Atherosclerosis imaging | ||||||||
| 99mTc | 99mTc annexin 5 |
|
Radiometal-tagged Annexin V | Apoptosis imaging | Lesion specific Limitation: weak signal intensity |
– | – | – |
| 68Ga | 68Ga DOTATATE |
|
Radiometal-tagged octreotide analog | Symptomatic carotid atherosclerosis Unstable angina |
Accumulates activated macrophages No physiological myocardial uptake Generator produced |
2016 | – | – |
| 64Cu | 64Cu DOTATATE |
|
Radiometal-tagged octreotide analog | Symptomatic carotid atherosclerosis | Good image quality | – | – | – |
| Translocator protein | ||||||||
| 11C | 11C-PK11195 |
|
Organic compound | Symptomatic carotid atherosclerosis | Accumulates in activated mononuclear phagocyte | – | – | – |
| 18F | 18F-FEDAC |
|
Organic compound | Accumulates in activated mononuclear phagocyte High affinity and better image quality |
– | – | – | |
| 18F | 18F-NaF | Inorganic anion | Aortic stenosis Coronary artery disease Carotid artery plaque |
Accumulates in calcification lesion | 2012 | – | – | |
68 Ga DOTATATE, Gallium-68-labeled [1,4,7,10-tetraazacyclododecane-N,N’,N’’,N’’’-tetraacetic acid]-d-Phe1, Tyr3-octreotate; 18 F-FDG, 18F-fluorodeoxyglucose; 18 F-FEDAC, N-benzyl-N-methyl-2-[7,8-dihydro-7-(2-[18F]fluoroethyl)-8-oxo-2-phenyl-9H-purin-9-yl]acetamide; WBC, white blood cell
*EURD List Juli 2017: http://www.ema.europa.eu/docs/en_GB/document_library/Other/2012/10/WC500133159.xls
**EURD list 2012 http://www.ema.europa.eu/docs/en_GB/document_library/Other/2012/04/WC500124999.xls