Neuroendocrine tumor (NET) metastases to the heart are found in 1%–4% of NET patients and have been reported primarily in the form of individual cases. We investigated the prevalence, clinical characteristics, imaging features, and outcomes of NET patients with cardiac metastases on ⁶⁸Ga-DOTATATE PET/CT. Methods: ⁶⁸Ga-DOTATATE PET/CT of 490 consecutive patients from a single institution were retrospectively reviewed for sites of metastases. The cumulative cardiovascular event rate and overall survival of patients with cardiac NET metastases (CNMs) were compared with those of a control group of metastatic NET patients without cardiac metastases. In patients with CNMs, the cardiac SUV_max with and without normalization to the myocardial background uptake was compared with a separate cohort of 11 patients with active cardiac sarcoidosis who underwent ⁶⁸Ga-DOTATATE PET/CT for research purposes. Results: In total, 270 patients with metastatic NETs were identified, 9 (3.3%) of whom had CNMs. All 9 patients had grade 1–2 gastroenteropancreatic NETs, most commonly from the small intestine (7 patients). The control group consisted of 140 patients with metastatic grade 1–2 gastroenteropancreatic NETs. On Kaplan–Meier analysis, there was no significant difference in the risk of cardiovascular adverse events (P = 0.91 on log-rank test) or mortality (P = 0.83) between the metastatic NET patients with and without cardiac metastases. The degree of cardiac DOTATATE uptake was significantly higher in CNMs than in patients with cardiac sarcoidosis without overlap, in terms of both cardiac SUV_max (P = 0.027) and SUV_max–to–myocardial background ratio (P = 0.021). Conclusion: Routine ⁶⁸Ga-DOTATATE PET/CT can be used to identify CNMs in 3% of patients with metastatic NETs. CNMs do not confer added cardiovascular or mortality risk. A distinguishing feature of CNMs is their high degree of DOTATATE uptake compared with focal myocardial inflammation.

神经内分泌肿瘤 （NET） 转移到心脏的患者中发现于 1%-4% 的 NET 患者，并且主要以个体病例的形式报告。我们调查了 ⁶⁸例 Ga-DOTATATE PET/CT 上心脏转移的 NET 患者的患病率、临床特征、影像学特征和结局。方法： 回顾性回顾来自单一机构的 490 例连续患者的 ⁶⁸例 Ga-DOTATATE PET/CT 转移部位。将心脏 NET 转移患者 （CNM） 的累积心血管事件发生率和总生存期与无心脏转移的转移性 NET 患者对照组进行比较。在 CNM 患者中，将心肌背景摄取正常化和不正常化的心脏 SUV_max 与一个单独的队列进行了 11 名活动性心脏结节病患者进行比较，这些患者接受了 ⁶⁸次 Ga-DOTATATE PET/CT 用于研究目的。结果：总共确定了 270 例转移性 NET 患者，其中 9 例 （3.3%） 患有 CNM。所有 9 例患者均患有 1-2 级胃肠胰 NET，最常见于小肠 （7 例患者）。对照组由 140 例转移性 1-2 级胃肠胰 NET 患者组成。在 Kaplan-Meier 分析中，有和没有心脏转移的转移性 NET 患者发生心血管不良事件的风险 （P = 0.91 log-rank test） 或死亡率 （P = 0.83） 没有显著差异。就心脏 SUV_max （P = 0.027） 和 SUV_max 与心肌背景比 （P = 0.021） 而言，CNM 的心脏 DOTATATE 摄取程度显著高于无重叠的心脏结节病患者。 结论：常规 ⁶⁸Ga-DOTATATE PET/CT 可用于识别 3% 的转移性 NET 患者的 CNM。CNM 不会增加心血管或死亡风险。CNM 的一个显着特征是与局灶性心肌炎症相比，它们的 DOTATATE 摄取程度高。