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FDG uptake patterns in isolated and systemic cardiac sarcoidosis

  • Original Article
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Journal of Nuclear Cardiology Aims and scope

Abstract

Aims

We aimed to investigate the pre-treatment characteristics and treatment responses of isolated and systemic cardiac sarcoidosis (ICS and SCS) from FDG-PET/CT studies and to compare the prognoses of the two groups.

Methods

FDG-PET/CT images taken before and after treatment of 31 ICS and 91 SCS patients were analyzed retrospectively. Treatment response and recurrence were determined from the course of FDG-PET/CT. Treatment response and the incidence of both recurrence and major adverse cardiac events (MACE) were assessed in 16 ICS and 35 SCS patients who had been treated for more than 2 years.

Results

A focal uptake pattern was more often observed than a focal-on-diffuse uptake pattern in both the ICS (74.2%) and SCS (63.7%) groups. Right ventricular involvement was significantly more frequent in SCS than ICS (44.0% vs. 9.6%, p < .001). SUVmax, cardiac metabolic volume (CMV), and cardiac metabolic activity (CMA) were significantly higher in SCS than ICS (SUVmax, 9.1 ± 4.1 vs. 4.8 ± 2.1; CMV, 118.0 ± 111.3 ml vs. 68.3 ± 94.7 ml; CMA, 541.6 ± 578.7 MBq vs. 265.1 ± 396.0 MBq, p < .001). Treatment responses in the two groups were similar, and complete resolution of cardiac uptake after immunosuppressive treatment was obtained in 62.5% of ICS patients and 77.1% of SCS patients (not significantly different). Likewise, no significant difference was found in the incidence of recurrence (40.0% for ICS, 44.4% for SCS) or MACE (25.0% for ICS, 22.8% for SCS).

Conclusion

SCS patients had more active and extensive CS lesions than ICS patients before treatment, but the two groups showed similar treatment responses and prognoses.

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Abbreviations

CS:

Cardiac sarcoidosis

ICS:

Isolated cardiac sarcoidosis

SCS:

Systemic cardiac sarcoidosis

FDG:

18F-fluorodeoxyglucose

PET/CT:

Positron emission tomography/computed tomography

CR:

Complete resolution

MACE:

Major adverse cardiac events

SUVmax:

Maximum standardized uptake value

CMV:

Cardiac metabolic volume

CMA:

Cardiac metabolic activity

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Acknowledgments

We thank all patients who participated in this study, and the nuclear medicine staff and nursing staff at the Tokyo Women’s Medical University Hospital for their commitment to providing excellent care for their patients.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Diagnostic Imaging & Nuclear Medicine, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Koichiro Kaneko MD, PhD, Michinobu Nagao MD, PhD, Atsushi Yamamoto MD, PhD & Shuji Sakai MD, PhD

  2. Department of Cardiology, Tokyo Women’s Medical University, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, 162-8666, Japan

    Atsushi Yamamoto MD, PhD & Akiko Sakai MD, PhD

Authors
  1. Koichiro Kaneko MD, PhD
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  2. Michinobu Nagao MD, PhD
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  3. Atsushi Yamamoto MD, PhD
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  4. Akiko Sakai MD, PhD
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  5. Shuji Sakai MD, PhD
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Correspondence to Koichiro Kaneko MD, PhD.

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Kaneko, K., Nagao, M., Yamamoto, A. et al. FDG uptake patterns in isolated and systemic cardiac sarcoidosis. J. Nucl. Cardiol. 30, 1065–1074 (2023). https://doi.org/10.1007/s12350-022-03106-1

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