炎症且易于破裂的冠状动脉斑块是心肌梗死的重要原因，早期识别至关重要。动脉粥样硬化斑块的特征是激活的巨噬细胞中类型2生长抑素受体（SST2）的过度表达。已经发现使用SST2配体显像（如[68 Ga]Ga-DOTA-TOC）在检测和定量评估动脉粥样硬化斑块的炎症活性方面显示出潜力。然而，标准轴向视野（SAFOV）PET扫描仪的敏感性对冠状动脉成像可能不够理想。长轴视野（LAFOV）PET/CT扫描仪可以帮助克服这一限制。我们的目标是评估[68 Ga]Ga-DOTA-TOC LAFOV-PET/CT在检测钙化、SST2过度表达的冠状动脉斑块的能力。 在这项回顾性研究中，对108名肿瘤学患者进行了LAFOV系统下的[68 Ga]Ga-DOTA-TOC PET/CT扫描。对冠状动脉的[68 Ga]Ga-DOTA-TOC摄取和钙化进行了视觉评估和半定量评估。还收集了患者的心脏危险因素和冠状动脉钙化评分的数据。对患者进行了21.5±3.4个月的随访。 共有66例患者（61.1%）出现了钙化的冠状动脉斑块。其中，32例患者至少有一个冠状血管中[68 Ga]Ga-DOTA-TOC的摄取增加（TBR：1.65±0.53）。单支血管钙化的患者的摄取明显较低（SUVmax：1.10±0.28），与双支（SUVmax：1.31±0.29，p<0.01）和三支血管钙化（SUVmax：1.24±0.33，p<0.01）的患者相比差异有统计学意义。冠状动脉钙化评分（CACS）与[68 Ga]Ga-DOTA-TOC的摄取存在相关性，尤其是左前降支（p=0.02）。随访期间，[68 Ga]Ga-DOTA-TOC摄取增加的患者中中风和全因死亡的发生率较高（分别为15.63% vs. 0%，p:0.001和21.88% vs. 6.58%，p:0.04）。 [68 Ga]Ga-DOTA-TOC作为巨噬细胞活性的标志物，可以使用LAFOV PET系统揭示炎症钙化的冠状动脉斑块的未知情况。[68 Ga]Ga-DOTA-TOC的摄取量随钙化程度的增加而增加，并与中风和全因死亡的风险增加相关。[68 Ga]Ga-DOTA-TOC LAFOV PET/CT可能有助于评估患者的心血管风险。© 2023. 作者。

Inflamed, prone-to-rupture coronary plaques are an important cause of myocardial infarction and their early identification is crucial. Atherosclerotic plaques are characterized by overexpression of the type-2 somatostatin receptor (SST2) in activated macrophages. SST2 ligand imaging (e.g. with [68 Ga]Ga-DOTA-TOC) has shown promise in detecting and quantifying the inflammatory activity within atherosclerotic plaques. However, the sensitivity of standard axial field of view (SAFOV) PET scanners may be suboptimal for imaging coronary arteries. Long-axial field of view (LAFOV) PET/CT scanners may help overcome this limitation. We aim to assess the ability of [68 Ga]Ga-DOTA-TOC LAFOV-PET/CT in detecting calcified, SST2 overexpressing coronary artery plaques.In this retrospective study, 108 oncological patients underwent [68 Ga]Ga-DOTA-TOC PET/CT on a LAFOV system. [68 Ga]Ga-DOTA-TOC uptake and calcifications in the coronary arteries were evaluated visually and semi-quantitatively. Data on patients' cardiac risk factors and coronary artery calcium score were also collected. Patients were followed up for 21.5 ± 3.4 months.A total of 66 patients (61.1%) presented with calcified coronary artery plaques. Of these, 32 patients had increased [68 Ga]Ga-DOTA-TOC uptake in at least one coronary vessel (TBR: 1.65 ± 0.53). Patients with single-vessel calcifications showed statistically significantly lower uptake (SUVmax 1.10 ± 0.28) compared to patients with two- (SUVmax 1.31 ± 0.29, p < 0.01) or three-vessel calcifications (SUVmax 1.24 ± 0.33, p < 0.01). There was a correlation between coronary artery calcium score (CACS) and [68 Ga]Ga-DOTA-TOC uptake, especially in the LAD (p = 0.02). Stroke and all-cause death occurred more frequently in patients with increased [68 Ga]Ga-DOTA-TOC uptake (15.63% vs. 0%; p:0.001 and 21.88% vs. 6.58%; p: 0.04, respectively) during the follow-up period.[68 Ga]Ga-DOTA-TOC as a marker for the macrophage activity can reveal unknown cases of inflamed calcified coronary artery plaques using a LAFOV PET system. [68 Ga]Ga-DOTA-TOC uptake increased with the degree of calcification and correlated with higher risk of stroke and all-cause death. [68 Ga]Ga-DOTA-TOC LAFOV PET/CT may be useful to assess patients' cardiovascular risk.© 2023. The Author(s).