Quantitative analysis of myocardial 18F-fluorodeoxyglucose uptake by PET/CT for detection of cardiac sarcoidosis

Yokoyama, Rami; Miyagawa, Masao; Okayama, Hideki; Inoue, Takeshi; Miki, Hitoshi; Ogimoto, Akiyoshi; Higaki, Jitsuo; Mochizuki, Takashi

doi:10.1016/j.ijcard.2015.05.075

Cited by 68 publications

(33 citation statements)

References 37 publications

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“…Though tracer uptake in damaged myocardium was almost twice as high as compared to the background of the left ventricular cavity or remote unaffected myocardium, SUV max of sarcoid lesions ranged between 1.4 and 5.0 and were therefore much lower than those reported for 18 F-FDG [21, 22]. However, since the myocardium does not display any physiologic 68 Ga-DOTATOC uptake, tracer retention in the heart can be considered specific.…”

Section: Discussionmentioning

confidence: 93%

Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI

et al. 2016

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Diagnosis of cardiac sarcoidosis is often challenging. Whereas cardiac magnetic resonance imaging (CMR) and positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) are most commonly used to evaluate patients, PET/CT using radiolabeled somatostatin receptor (SSTR) ligands for visualization of inflammation might represent a more specific alternative. This study aimed to investigate the feasibility of SSTR–PET/CT for detecting cardiac sarcoidosis in comparison to CMR.15 patients (6 males, 9 females) with sarcoidosis and suspicion on cardiac involvement underwent SSTR-PET/CT imaging and CMR. Images were visually scored. The AHA 17-segment model of the left myocardium was used for localization and comparison of inflamed myocardium for both imaging modalities. In semi-quantitative analysis, mean (SUVmean) and maximum standardized uptake values (SUVmax) of affected myocardium were calculated and compared with both remote myocardium and left ventricular (LV) cavity.SSTR-PET was positive in 7/15, CMR in 10/15 patients. Of the 3 CMR+/PET− subjects, one patient with minor involvement (<25% of wall thickness in CMR) was missed by PET. The remaining two CMR+/PET− patients displayed no adverse cardiac events during follow-up.In the 17-segment model, PET/CT yielded 27 and CMR 29 positive segments. Overall concordance of the 2 modalities was 96.1% (245/255 segments analyzed). SUVmean and SUVmax in inflamed areas were 2.0±1.2 and 2.6±1.2, respectively. The lesion-to-remote myocardium and lesion-to-LV cavity ratios were 1.8±0.2 and 1.9±0.2 for SUVmean and 2.0±0.3 and 1.7±0.3 for SUVmax, respectively.Detection of cardiac sarcoidosis by SSTR-PET/CT is feasible. Our data warrant further analysis in larger prospective series.

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Section: Discussionmentioning

confidence: 93%

Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI

et al. 2016

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“…Cardiac inflammation can be evaluated using 67 Ga scanning, gadolinium-enhanced cardiac magnetic resonance imaging, and 18 F-FDG PET. Recently, 18 F-FDG PET has been widely reported to provide useful information on the disease activity of CS owing to its greater sensitivity compared to 67 Ga scanning [5,6].…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, the maintenance steroid dose should be reduced as much as possible, although we cannot identify the selected patients in whom we can discontinue corticosteroids. Fluorine-18-fluorodeoxyglucose positron emission tomography ( 18 F-FDG PET) plays an important role in the evaluation of the activity of inflammation and to guide immunosuppression in patients with CS [4][5][6]. However, it is unknown whether we can taper and stop corticosteroids when abnormal 18 F-FDG uptake in the myocardium is not seen in every examination.…”

Section: Introductionmentioning

confidence: 99%

Failure of steroid withdrawal guided by 18 F-FDG PET in a patient with cardiac sarcoidosis

Takeuchi

Yazaki

Okada

et al. 2017

Journal of Cardiology Cases

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“…In the inflammatory cells, cellular activation increases both GLUT1 and GLUT3 but not GLUT4 expression. 18 F-FDG-6-P: FDG-6-phosphate, Glucose-6-P: glucose-6-phosphate, GLUT: glucose transporter protein, TCA: tricarboxylic acid cycle IU/kg, 15 min prior to FDG administration has been adopted, which increases serum FFA levels rapidly after heparin injection (9)(10)(11)(18)(19). On the other hand, although subject's body weights were not mentioned.…”

Section: Dietary Modification Prior To Fdg-petmentioning

confidence: 99%

Optimal Patient Preparation for Detection and Assessment of Cardiac Sarcoidosis by FDG-PET

Miyagawa

Tashiro

Watanabe

et al. 2017

Annals of Nuclear Cardiology

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Abnormal uptake of 18 F-fluorodeoxyglucose (FDG) in the heart on positron emission tomography (PET) was recently included in the major criteria of diagnostic guidelines for cardiac sarcoidosis (CS). The high sensitivity but great variability in specificity in the diagnosis probably due to variable preparation methodologies of FDG-PET was reported. There are three main methods which have been reported to minimize physiological FDG uptake in the normal myocardium. A low carbohydrate diet on the day before PET with an overnight fasting more than 18-h achieves almost complete suppression of myocardial FDG uptake. Use of heparin pre-injection or high-fat diet preparation may enhance the suppressive effect. Serum FFA levels before PET imaging might be a biomarker of predicting the physiological FDG uptake in the myocardium.

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Quantitative analysis of myocardial 18F-fluorodeoxyglucose uptake by PET/CT for detection of cardiac sarcoidosis

Cited by 68 publications

References 37 publications

Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI

Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI

Failure of steroid withdrawal guided by 18 F-FDG PET in a patient with cardiac sarcoidosis

Optimal Patient Preparation for Detection and Assessment of Cardiac Sarcoidosis by FDG-PET

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