First-In-Human Study of [⁶⁴Cu]Cu-DOTATATE PET/CT in Infective Endocarditis: A Prospective Head-to-Head Comparison...

Area of Science:

• Nuclear medicine
• Radiopharmacology
• Cardiovascular imaging

Background:

• Infective endocarditis (IE) diagnosis is challenging.
• [18F]FDG PET/CT is recommended but has limitations.
• Novel tracers are needed to improve diagnostic accuracy.

Purpose of the Study:

• Compare [64Cu]Cu-DOTATATE with [18F]FDG PET/CT for IE diagnosis.
• Evaluate tracer uptake, sensitivity, and specificity.
• Assess diagnostic certainty without dietary restrictions.

Main Methods:

• Prospective CuDOS study included 20 IE patients and 20 controls.
• All participants underwent [64Cu]Cu-DOTATATE and [18F]FDG PET/CT.
• Tracer uptake measured as maximum standardized uptake values; scans read blinded.

Main Results:

• [64Cu]Cu-DOTATATE uptake was higher in IE patients, especially with prosthetic valves (P=0.008).
• Sensitivity was equal for both tracers; specificity was 90% for [64Cu]Cu-DOTATATE vs. 75% for [18F]FDG.
• [64Cu]Cu-DOTATATE achieved greater diagnostic certainty.

Conclusions:

• [64Cu]Cu-DOTATATE PET/CT shows potential for IE diagnosis with advantages over [18F]FDG.
• No fasting required for [64Cu]Cu-DOTATATE, improving patient convenience.
• Both tracers had limitations in detecting native valve endocarditis.