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Infectious myocarditis are frequent, most of the time viral and can evolve to cardiac insufficiency. The diagnosis is difficult because they can mime an acute coronary syndrome. Approximately 10 % of patients with acute infarction suspected, have a normal angiography, and half of them has in fact a myocarditis, as showed studies of cardiac MRI among which some realized in our department . However, anomalies observed in MRI are not specific and it is necessary to use multiple criterions. A new radiopharmaceutical, the 68Ga-DOTATOC, specific of somatostatin's receptors which are over expressed by the inflammatory cells, has recently showed the capacity to identify myocarditis, but only in a small group of 6 patients.
The investigators make assumptions:
Primary objectif: to determine if PET with 68Ga-DOTATOC is enough sensitive to identify myocarditis in acute inflammatory phase by hospitalized patients with suspected acute infarction and with normal angiography and who have a high probability of myocarditis identified by MRI. Disease prevalence will be close to 100 % at baseline Secondary objectives: 1. Estimate the frequency of inflammatory forms (subacute or chronicle), with a 68Ga-DOTATOC PET at 3 to 5 months from baseline, when classic signs of acute inflammatory generally disappeared (CRP, Troponin-I, myocardial oedema in MRI).
2. Analyze the concordance of the results of 68Ga-DOTATOC TEP by two readers
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Experimental arm | Experimental | All included patients wil receive 68Ga-dotatoc-PET/CT suspected acute myocarditis in first and an other 68Ga-dotatoc-PET/CT 6 months later |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| DOTATOC-68Ga PET initial | Drug | DOTATOC is a tracer of high affinity for the type 2 somatostatin receptors and is used for imaging of tumours which are expressing them, including endocrine tumours |
| Measure | Description | Time Frame |
|---|---|---|
| Presence of a significant myocardial retention of 68Ga-DOTATOC during initial staging. Sensibility calculation | The criterion of positivity will be that of a visually detectable and quantitatively significant area of myocardial uptake, which will be defined by a measurement of the Standardized Uptake Value (SUV) at least 30% higher than that of the blood signal obtained at the center of the left ventricular cavity. This threshold was chosen based on measurements already published in a small pilot study. | at baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Frequency of a significant myocardial retention of 68Ga-DOTATOC during initial staging | a visually detectable and quantitatively significant area of myocardial uptake, which will be defined by a measurement of the Standardized Uptake Value (SUV) at least 30% higher than that of the blood signal obtained at the center of the left ventricular cavity. This threshold was chosen based on measurements already published in a small pilot study. a visually detectable and quantitatively significant area of myocardial uptake, which will be defined by a measurement of the Standardized Uptake Value (SUV) at least 30% higher than that of the blood signal obtained at the center of the left ventricular cavity. This threshold was chosen based on measurements already published in a small pilot study. visually detectable and quantitatively significant area of myocardial uptake, which will be defined by a measurement of the Standardized Uptake Value (SUV) at least 30% higher than that of the blood signal obtained at the center of the left ventricular cavity. |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Elodie CHEVALIER, MD | CHRU de NANCY | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Véronique ROCH | Vandœuvre-lès-Nancy | 54511 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 38991751 | Result | Larive T, Boursier C, Claudin M, Varlot J, Filippetti L, Huttin O, Roch V, Imbert L, Doyen M, Lambert A, Mandry D, Lamiral Z, Chevalier E, Marie PY. Factors Associated with Myocardial Uptake on Oncologic Somatostatin PET Investigations and Differentiation from Myocardial Uptake of Acute Myocarditis. J Nucl Med. 2024 Aug 1;65(8):1279-1285. doi: 10.2967/jnumed.123.267219. | |
| 40119896 |
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| ID | Term |
|---|---|
| D009205 | Myocarditis |
| ID | Term |
|---|---|
| D009202 | Cardiomyopathies |
| D006331 | Heart Diseases |
| D002318 | Cardiovascular Diseases |
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| ID | Term |
|---|---|
| D001800 | Blood Specimen Collection |
| ID | Term |
|---|---|
| D013048 | Specimen Handling |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
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|
| DOTATOC-68Ga PET at 6 months | Drug | DOTATOC is a tracer of high affinity for the type 2 somatostatin receptors and is used for imaging of tumours which are expressing them, including endocrine tumours |
|
|
| blood sample | Biological | blood tests will be carried out during the control visit to ensure that biological parameters are normalized |
|
| 6 months |
| Larive T, Boursier C, Claudin M, Varlot J, Filippetti L, Huttin O, Roch V, Imbert L, Doyen M, Fraix A, Mandry D, Chevalier E, Marie PY. Persistent somatostatin PET signs of inflammatory cells 4 to 5 months after acute myocarditis are linked to a poorer recovery of cardiac function. Eur J Nucl Med Mol Imaging. 2025 Jul;52(9):3395-3403. doi: 10.1007/s00259-025-07202-5. Epub 2025 Mar 22. |
| D011677 | Punctures |
| D013514 | Surgical Procedures, Operative |
| D008919 | Investigative Techniques |