Which is the proper reference tissue for measuring the change in FDG PET metabolic volume of cardiac sarcoidosis before and after steroid therapy?

Furuya, Shinichi; Manabe, Osamu; Ohira, Hiroshi; Hirata, Kenji; Aikawa, Tadao; Naya, Masanao; Tsujino, Ichizo; Koyanagawa, Kazuhiro; Anzai, Toshihisa; Oyama‐Manabe, Noriko; Shiga, Tohru

doi:10.1186/s13550-018-0447-8

Cited by 18 publications

(22 citation statements)

References 30 publications

(48 reference statements)

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“…This causes a higher increase in FDG uptake in the liver than in the bone marrow and spleen and therefore lower bone marrow-to-liver and spleen-to-liver ratios. Treatment with corticosteroids can also increase glucose level and hepatic FDG uptake [ 29 ], but BLR or SLR was not independently associated with receiving immunosuppressive drugs (of which 85% were corticosteroids) in our patient population.…”

Section: Discussionmentioning

confidence: 75%

“…With cardiovascular infections such as endocarditis and infected vascular grafts, bacteria are constantly hematogenously spread through the body. Eradication of the pathogen usually requires up to 6 weeks of intravenous antibiotic therapy [ 29 ]. These infections are usually considered severe and as such may also evoke a more severe inflammatory response throughout the body, including the bone marrow and spleen.…”

Section: Discussionmentioning

confidence: 99%

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Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Pijl

Kwee

Slart

et al. 2020

Eur J Nucl Med Mol Imaging

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Purpose To investigate which clinical factors and laboratory values are associated with high FDG uptake in the bone marrow and spleen on 2-deoxy-2-[18F]fluoro-d-glucose (FDG) positron emission tomography (PET)/computed tomography (CT) in patients with bacteremia. Methods One hundred forty-five consecutive retrospective patients with bacteremia who underwent FDG-PET/CT between 2010 and 2017 were included. Mean standard uptake values (SUVmean) of FDG in bone marrow, liver, and spleen were measured. Bone marrow-to-liver SUV ratios (BLR) and spleen-to-liver SUV ratios (SLR) were calculated. Linear regression analyses were performed to examine the association of BLR and SLR with age, gender, hemoglobin, leukocyte count, platelets, glucose level, C-reactive protein (CRP), microorganism, days of antibiotic treatment before FDG-PET/CT, infection focus, use of immunosuppressive drugs, duration of hospital stay (after FDG-PET/CT), ICU admission, and mortality. Results C-reactive protein (p = 0.006), a cardiovascular or musculoskeletal focus of infection (p = 0.000 for both), and bacteremia caused by Gram-negative bacteria (p = 0.002) were independently and positively associated with BLR, while age (p = 0.000) and glucose level before FDG-PET/CT (p = 0.004) were independently and negatively associated with BLR. For SLR, CRP (p = 0.001) and a cardiovascular focus of infection (p = 0.020) were independently and positively associated with SLR, while age (p = 0.002) and glucose level before FDG-PET/CT (p = 0.016) were independently and negatively associated with SLR. Conclusion High FDG uptake in the bone marrow is associated with a higher inflammatory response and younger age in patients with bacteremia. In patients with high FDG uptake in the bone marrow, a cardiovascular or musculoskeletal focus of infection is more likely than other foci, and the infection is more often caused by Gram-negative species. High splenic FDG uptake is associated with a higher inflammatory response as well, and a cardiovascular focus of infection is also more likely in case of high splenic FDG uptake.

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Section: Discussionmentioning

confidence: 75%

Section: Discussionmentioning

confidence: 99%

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Pijl

Kwee

Slart

et al. 2020

Eur J Nucl Med Mol Imaging

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“…One of the reasons is that inter-observer variations are introduced depending on the reference ROI, as normal tissues such as muscle and liver which have, to some extent, heterogeneous activity. Exceptions are brain tumours, where L/N ratio calculated by the contralateral cerebral cortex or cerebellum is preferred to standardized uptake value (SUV) [ 25 ], and cardiac sarcoidosis, for which L/N ratio is calculated using the blood pool of the descending aorta or liver [ 26 ].…”

Section: Basic Concepts For Quantitative Fdg Pet Assessmentmentioning

confidence: 99%

Quantitative FDG PET Assessment for Oncology Therapy

Hirata

Tamaki

2021

Cancers

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Positron emission tomography (PET) has unique characteristics for quantitative assessment of tumour biology in vivo. Accumulation of F-18 fluorodeoxyglucose (FDG) may reflect tumour characteristics based on its metabolic activity. Quantitative assessment of FDG uptake can often be applied for treatment monitoring after chemotherapy or chemoradiotherapy. Numerous studies indicated biochemical change assessed by FDG PET as a more sensitive marker than morphological change estimated by CT or MRI. In addition, those with complete metabolic response after therapy may show better disease-free survival and overall survival than those with other responses. Assessment of metabolic change may be performed using absolute FDG uptake in the tumour (standardized uptake value: SUV). In addition, volumetric parameters such as metabolic tumour volume (MTV) have been introduced for quantitative assessment of FDG uptake in tumour. More recently, radiomics approaches that focus on image-based precision medicine have been applied to FDG PET, as well as other radiological imaging. Among these, texture analysis extracts intratumoral heterogeneity on a voxel-by-voxel basis. Combined with various machine learning techniques, these new quantitative parameters hold a promise for assessing tissue characterization and predicting treatment effect, and could also be used for future prognosis of various tumours, although multicentre clinical trials are needed before application in clinical settings.

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“…The 18F-FDG PET has proven to be a good technique to follow patients undergoing immunosuppressive treatment and to evaluate the therapy response, with the ability to quantify inflammation using the standardized absorption value (SUV). The 18F-FDG PET can be useful to orient the most appropriate immunosuppressive therapy, the duration of treatment and drug dosage [ 61 , 62 , 63 ].…”

Section: 18f-fdg Pet Study Of Cardiac Sarcoidosismentioning

confidence: 99%

Clinical Features and Diagnosis of Cardiac Sarcoidosis

Tana

Mantini

Donatiello

et al. 2021

JCM

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Cardiac sarcoidosis (CS) is an unusual, but potentially harmful, manifestation of systemic sarcoidosis (SA), a chronic disease characterized by organ involvement from noncaseating and nonnecrotizing granulomas. Lungs and intrathoracic lymph nodes are usually the sites that are most frequently affected, but no organ is spared and CS can affect a variable portion of SA patients, up to 25% from post-mortem studies. The cardiovascular involvement is usually associated with a bad prognosis and is responsible for the major cause of death and complications, particularly in African American patients. Furthermore, the diagnosis is often complicated by the occurrence of non-specific clinical manifestations, which can mimic the effect of more common heart disorders, and imaging and biopsies are the most valid approach to avoid misdiagnosis. This narrative review summarizes the main clinical features of CS and imaging findings, particularly of CMR and 18-Fluorodeoxyglucose Positron Emission Tomography (18F-FDG PET) that can give the best cost/benefit ratio in terms of the diagnostic approach. Imaging can be very useful in replacing the endomyocardial biopsy in selected cases, to avoid unnecessary, and potentially dangerous, invasive maneuvers.

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Which is the proper reference tissue for measuring the change in FDG PET metabolic volume of cardiac sarcoidosis before and after steroid therapy?

Cited by 18 publications

References 30 publications

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Clinical implications of increased uptake in bone marrow and spleen on FDG-PET in patients with bacteremia

Quantitative FDG PET Assessment for Oncology Therapy

Clinical Features and Diagnosis of Cardiac Sarcoidosis

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