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Diagnostic values of delayed additional FDG PET/CT scan in the evaluation of cardiac sarcoidosis

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Abstract

Objective

This study aimed to compare the contribution of 18F-fluorodepxyglucose (FDG) positron (PET)/ computed tomography (CT) acquisition of early and delayed scans in patients with cardiac sarcoidosis (CS).

Methods

Twenty-three patients with CS (median age: 69 years; 11 women) were retrospectively evaluated using dual-phase FDG PET/CT. All patients were instructed to consume a low-carbohydrate diet followed by fasting for 18 h before FDG injection to reduce physiological myocardial uptake. PET/CT was acquired at 60 min (early) and 100 min (delayed) after FDG administration. Focal and focal on diffuse uptake on visual analysis was considered positive for CS. A semi-quantitative analysis was performed using the maximum standardized uptake value (SUVmax) of the cardiac lesion and the mean SUV (SUVmean) of the blood pool.

Results

Significant myocardial FDG uptake was observed in 21 patients (91.3%) in the early acquisition group and in 23 patients in the delayed scan group (100%). Compared to the early scan, the delayed scan showed a significantly higher SUVmax of the cardiac lesion [median, 4.0; IQR (interquartile range, 2.9 to 7.0) vs. 5.8 (IQR 3.7 to 10.1); P = 0.0030] and a significantly lower SUVmean of blood pool [median, 1.3 (IQR, 1.2 to 1.4) vs. 1.1 (IQR, 0.9 to 1.2); P < 0.0001].

Conclusion

Delayed FDG PET/CT acquisition improves detection accuracy in patients with CS compared to early scans with washout of the blood pool activity. Therefore, it can contribute to a more accurate assessment of CS.

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Data availability

The datasets used and/or analyzed in the current study are available from the corresponding author upon request.

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Acknowledgements

We would like to thank Editage (www.editage.com) for English language editing.

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Author notes

  1. Osamu Manabe and Keiko Takahashi contributed equally to this work as co-first authors.

Authors and Affiliations

  1. Department of Radiology, Jichi Medical University Saitama Medical Center, 1-847 Amanuma-Cho, Omiya-Ku, Saitama, 330-8503, Japan

    Osamu Manabe, Keiko Takahashi, Tadao Aikawa & Noriko Oyama-Manabe

  2. Central Division of Radiology, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Hiroki Kawakami & Akira Ohtsuka

  3. Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu, Japan

    Tadao Aikawa

  4. Department of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center, Saitama, Japan

    Hisataka Maki, Tatsuro Ibe & Hideo Fujita

Authors
  1. Osamu Manabe
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  2. Keiko Takahashi
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  3. Hiroki Kawakami
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  4. Akira Ohtsuka
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  8. Hideo Fujita
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  9. Noriko Oyama-Manabe
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Contributions

OM and KT contributed to the conception and design of this study. HK, AO, and KT prepared the materials and collected the data. OM and KT performed the data analysis. OM and KT wrote the first draft of this manuscript. All authors commented on the previous versions of the manuscript. All the authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Noriko Oyama-Manabe.

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Conflict of interest

Dr. Noriko Oyama-Manabe received payments from Bayer Yakuhin Ltd. and Canon Medical Systems for lectures. The other authors declare no financial conflicts of interest.

Ethical statement

Institutional ethics review board approval was obtained, and the requirement for informed consent was waived for this retrospective study. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Manabe, O., Takahashi, K., Kawakami, H. et al. Diagnostic values of delayed additional FDG PET/CT scan in the evaluation of cardiac sarcoidosis. Ann Nucl Med 37, 535–540 (2023). https://doi.org/10.1007/s12149-023-01855-8

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  • DOI: https://doi.org/10.1007/s12149-023-01855-8

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