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Background  Ga-[1,4,7,10-tetraazacyclododecane- N , N ′, N ″, N ′″ - tetraacetic acid]-d-Phe 1 ,Tyr 3 -octreotate (DOTATATE) positron emission tomography (PET) is commonly used for the visualization of somatostatin receptor (SSTR)-positive neuroendocrine tumors. SSTR is also known to be expressed on macrophages, which play a major role in inflammatory processes in the walls of coronary arteries and large vessels. Therefore, imaging SSTR expression has the potential to visualize vulnerable plaques. We assessed  68 Ga-DOTATATE accumulation in large vessels in comparison to  18 F-2-fluorodeoxyglucose (FDG) uptake, calcified plaques (CPs), and cardiovascular risk factors.    Methods  Sixteen consecutive patients with neuroendocrine tumors or thyroid cancer underwent both  68 Ga-DOTATATE and  18 F-FDG PET/CT for staging or restaging purposes. Detailed clinical data, including common cardiovascular risk factors, were recorded. For a separate assessment, they were divided into a high-risk and a low-risk group. In each patient, we calculated the maximum target-to-background ratio (TBR) of eight arterial segments. The correlation of the TBR mean  of both tracers with risk factors including plaque burden was assessed.    Results  The mean TBR of  68 Ga-DOTATATE in all large arteries correlated significantly with the presence of CPs ( r  = 0.52;  p  < 0.05), hypertension ( r  = 0.60;  p  < 0.05), age ( r  = 0.56;  p  < 0.05), and uptake of  18 F-FDG ( r  = 0.64;  p  < 0.01). There was one significant correlation between  18 F-FDG uptake and hypertension (0.58;  p  < 0.05). Out of the 37 sites with the highest focal  68 Ga-DOTATATE uptake, 16 (43.2%) also had focal  18 F-FDG uptake. Of 39 sites with the highest  18 F-FDG uptake, only 11 (28.2%) had a colocalized  68 Ga-DOTATATE accumulation.    Conclusions  In this series of cancer patients, we found a stronger association of increased  68 Ga-DOTATATE uptake with known risk factors of cardiovascular disease as compared to  18 F-FDG, suggesting a potential role for plaque imaging in large arteries. Strikingly, we found that focal uptake of  68 Ga-DOTATATE and  18 F-FDG does not colocalize in a significant number of lesions.

68Ga-DOTATATE PET/CT for the detection of inflammation of large arteries: correlation with18F-FDG, calcium burden and risk factors