FDG-PET as an Imaging Modality to Diagnose and Risk Stratify Subclinical, Imaging Negative Ici-Myocarditis

Mayo Clinic

Status

Enrolling

Conditions

Hematologic Malignancy

ICI-Myocarditis

Solid Malignant Tumor

Myocarditis

Subclinical ICI-myocarditis

Subclinical Myocarditis

Subclinical Immune Checkpoint Inhibitor-Induced Myocarditis

Treatments

Device: Fluorodeoxyglucose - Positron Emission Tomography (FDG-PET)

Study type

Observational

Funder types

Other

Identifiers

NCT06566209

24-001222

NCI-2024-06871 (Registry Identifier)

Details and patient eligibility

About

The purpose of this pilot study is to evaluate Fluorodeoxyglucose - Positron Emission Tomography (FDG-PET) as an imaging modality to diagnose and risk stratify subclinical, imaging negative ICI-myocarditis, and to determine whether subclinical ICI-induced myocarditis is a distinct and clinically relevant entity with a risk of progression to fulminant myocarditis.

Enrollment

30 estimated patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

Age ≥18 years at the time of signing informed consent
Any solid or hematologic malignancy undergoing treatment with ICI (either as a single agent or in combination with others)
Ambulatory and able to complete a 48-72 hour high fat and low carbohydrate diet with 18 hours fasting (PET diet), 18F-FDG PET/CT scanning, as well as 13N-ammonia PET-CT myocardial perfusion imaging (part of the routine protocol of the investigation). These two studies will be done as part of the same imaging set.
Willing to return to Mayo Clinic for ongoing follow-up
Left ventricular ejection fraction (LVEF) ≥45%
Cardiac MRI (CMR) without conclusive evidence of inflammation, coronary assessment available (either via cardiac computed tomography angiography, CCTA, or via coronary angiogram) Informed consent obtained before any trial-related activities. Trial-related activities are any procedures that are carried out as part of the trial, including activities to determine suitability for the trial.

Exclusion criteria

Fulminant myocarditis requiring steroid therapy
CMR with definitive evidence of myocarditis
Clinical presentation consistent with acute coronary syndrome (wall motion abnormalities consistent with a specific coronary distribution, coronary angiogram with a culprit lesion identified, patients requiring revascularization either with percutaneous coronary interventions or coronary artery bypass grafting).
Patients unable to provide informed consent
Patients unable to complete the diet preparation protocol
Pregnancy (all women of child-bearing age and potential will have a negative pregnancy test within 48 hours of the PET/CT at screen and 6-month visit)
Breastfeeding