Immune checkpoint inhibitor-associated cardiotoxicity detected by 68Ga-DOTATATE PET/CT and 68Ga-FAPI PET/CT

The growing clinical use of immune checkpoint inhibitors (ICIs) has made significant progress in the treatment of various subsets of tumours. Nonetheless, potential cardiotoxicity and autoimmune adverse events with ICI were considered. Multiple cardiac molecular injuries induced by ICIs had not been well investigated. A 75-year-old male with advanced upper tract urothelial carcinoma was treated with, and subsequently presented fatigue and dyspnoea, palpitations, myalgia, as well as intermittent coughing sputum and dizziness in 2 weeks. Computed tomographic angiography (CTA) examination showed mild stenosis on the left main coronary artery. Cardiac magnetic resonance (CMR) recognized abnormal ventricular motion with corresponding left ventricular ejection fraction (LVEF) 46%, end-diastolic volume (EVD) of 106.4 mL, but absent evidential cardiomyopathy features, echo examination indicated left ventricular (LV) hypertrophy coupled with severe cardiac dysfunction (ejection fraction (EF) 38%). NT-proBNP of 4140 pg/mL cTnl of 125.8 pg/mL were recorded. Somatostatin Subtype Receptor 2 (SST2) imaging by Ga-68...