Vascular Inflammation Imaging Using Somatostatin Receptor Positron Emission Tomography - The Vision Study. (360G-Wellcome-104492_Z_14_Z)

Clinical events in atherosclerosis are largely driven by inflammation. Molecular atherosclerosis imaging can potentially identify high-risk lesions, help guide treatment and illuminate underlying pathophysiology. 18F-FDG PET is the gold-standard nuclear molecular imaging technique with well-established roles in atherosclerosis imaging. However, the arterial 18F-FDG signal is non-specific for inflammation and coronary artery imaging is difficult due to high background myocardial uptake. 68Ga-DOTA NOC is a somatostatin receptor PET tracer used in cancer imaging, which we think is more specific for inflammation and lacks myocardial uptake. VISION is a prospective study designed to investigate plaque inflammation using 68Ga-DOTANOC PET. In the proposed study, 50 participants with atherosclerosis will undergo sequential 68Ga-DOTANOC and 18F-FDG PET imaging, along with CT carotid and coronary angiography. Autoradiography and immunohistochemistry of excised carotid plaques will be used to vali date imaging data. Post-hoc computational imaging analysis will also be performed to derive mechanical stress patterns in relation to vascular inflammation detected by 68Ga-DOTANOC. If successful, 68Ga-DOTANOC imaging will offer a cheaper, more specific non-invasive measure of inflammation than 18F-FDG, particularly in the coronary arteries. This should result in better risk stratification for patients with atherosclerosis and could provide a non-invasive platform to test the effects of novel an ti-atherosclerosis drugs.