학술논문

Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis.
Document Type
Academic Journal
Source
Journal of Nuclear Cardiology (J NUCL CARDIOL), Oct2014; 21(5): 925-939. (15p)
Subject
Language
English
ISSN
1071-3581
Abstract
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.