Images that TeachSubacute myocardial infarction detected by technetium-99m-labeled somatostatin analog scintigraphy
Introduction
Recently, the applicability of somatostatin receptor-targeted (SSTR-t) radiotracers for post-ischemic myocardial inflammation imaging has been shown using PET.1, 2, 3 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).
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Case Summary
A 51-year-old male with acute chest pain of 7 hours of duration was admitted to our hospital. He had QS in leads V1-V3 and ST elevation in leads V2-V3 in the electrocardiogram. Echocardiography showed hypokinesis of the apex, septum and anterior wall of the left ventricular (LV) and LV ejection of 44%. Troponin I level was elevated up to 3.81 ng·mL−1. Emergency invasive coronary angiography revealed acute occlusion of the mid segment of left anterior descending artery and atherosclerotic
Discussion
This case demonstrated the applicability of technetium-99m-labeled SSTR-t radiotracers for post-infarction inflammation imaging. Significant is that 99mTc-Tectrotide uptake area was matched with areas of hypoperfusion (by SPECT) and myocardial injury (by MRI). While cardiac MRI depicts myocardium damage or scarring and MPS shows zones of impaired blood flow, SSTR-t radiotracers, as currently assumed,1, 2, 3 reflect an increased number of activated macrophages infiltrating infarcted myocardium.
Disclosures
S.I. Sazonova, A.G. Syrkina, O.V. Mochula, Zh.Zh. Anashbaev, E.V. Popov and V.V. Ryabov declare that they have no conflict of interest.
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(68)Ga-DOTATATE PET identifies residual myocardial inflammation and bone marrow activation after myocardial infarction
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Cited by (4)
Targeted imaging: the key for direct visualization of myocardial inflammation in patients?
2023, Journal of Nuclear CardiologyPotential utility of SPECT/CT with 99mTc-Tektrotyd for imaging of post-myocardial infarction inflammation
2023, Journal of Nuclear Cardiology