Evaluation of FDG PET combined with cardiac MRI for the diagnosis and therapeutic monitoring of cardiac sarcoidosis
| Autor: | C. Meune, P.-Y. Brillet, Diane Bouvry, Michael Soussan, Hilario Nunes, S. Djelbani, Dominique Valeyre, B. Sgard |
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| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Sarcoidosis Cardiac sarcoidosis 030218 nuclear medicine & medical imaging 03 medical and health sciences Young Adult 0302 clinical medicine Cardiac magnetic resonance imaging Fluorodeoxyglucose F18 Medicine Humans Radiology Nuclear Medicine and imaging In patient Pathological Aged Aged 80 and over medicine.diagnostic_test business.industry Myocardium Heart General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Confidence interval Therapeutic monitoring 030220 oncology & carcinogenesis Positron-Emission Tomography Female Tomography business Nuclear medicine Cardiomyopathies |
| Zdroj: | Clinical radiology. 74(1) |
| ISSN: | 1365-229X |
| Popis: | AIM To compare combined 2-[18F]-fluoro-2-deoxy- d- glucose (FDG)-positron-emission tomography (PET) and cardiac magnetic resonance imaging (CMR) for the diagnosis and therapy monitoring of cardiac sarcoidosis (CS). MATERIALS AND METHODS Eighty patients with sarcoidosis and a suspicion of CS who underwent PET and CMR were included retrospectively. PET was undertaken after a low-carbohydrate–high-fat diet in all patients using a combined 16-section PET/computed tomography (CT) camera. PET was considered positive (PET+) in cases of focal or multifocal FDG uptake. CMR was considered positive (CMR+) in cases of subepicardial late gadolinium enhancement (LGE). A subgroup of 50 patients (50/80) was monitored during therapy and classified as responders or non-responders. RESULTS Eighty-two percent of patients with PET+ (9/11) also had CMR+ imaging, with good spatial agreement (kappa=0,79; 95% confidence interval [CI]: 0.65–0.94). Twenty-seven percent (22/80) had residual physiological FDG uptake, with a standardised uptake value (SUV) not significantly different compared to the SUV from pathological uptake (6.4 versus 6 respectively, p=0,92). The clinical response was more frequent in patients with baseline PET+ compared to baseline PET– (80% versus 45%, p=0.07). PET findings improved in all cases under treatment (7/7), whereas LGE improved in only 33% of patients (3/9). CONCLUSION Due to high risk of false-positive or undetermined findings, PET might be performed as a second-line study in cases of LGE, to assess inflammatory load. In addition, PET seems suitable to predict and assess response under therapy. |
| Databáze: | OpenAIRE |
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