Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis
Background: FDG PET/CT with myocardial perfusion imaging is a useful method for evaluating cardiac sarcoidosis (CS), but interpretation is not standardized. We developed a method for quantification of cardiac FDG PET/CT and evaluated its relationship to conventional interpretation, perfusion defects, clinical events, and immunosuppressive treatment. Methods and Results: FDG PET/CT with MPI studies performed for CS (n = 38) were retrospectively compared to negative control studies acquired for oncologic indications (n = 10). Quantitative measures of FDG volume-intensity (Cardiac Metabolic Activity, CMA) was performed using standardized uptake values (SUVs). CMA (477.7 ± 909 vs 0.55 ± 2.1 vs 0.3 ± 0.3 g glucose, P =.02) was significantly greater in visually FDG-positive studies compared to visually negative and oncologic negative studies. Among patients with CS, CMA was greater in studies with an EF < 50% (760.3 ± 1,148 vs 87.4 ± 161 g glucose, P =.03) and preceding an adverse clinical event (1,095 ± 1,253 vs 73 ± 144 g glucose, P =.006). CMA was the only independent predictor of events by multivariate analysis. In patients with repeat examinations (n = 7), CMA decreased with prednisone treatment in 5 of 6 patients. Conclusions: Quantification of FDG uptake in CS correlates with lower EFs, clinical events, and immunosuppression treatment.
Journal of Nuclear Cardiology
Ahmadian, A., Brogan, A., Berman, J., Sverdlov, A., Mercier, G., Mazzini, M., Govender, P., & Ruberg, F. (2014). Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis. Journal of Nuclear Cardiology, 21 (5), 925-939. https://doi.org/10.1007/s12350-014-9901-9