FDG PET-CT findings of extra-thoracic sarcoid are associated with cardiac sarcoid: A rationale for using FGD PET-CT for cardiac sarcoid evaluation
- 790 Downloads
This retrospective study investigates the relationship between cardiac and extra-thoracic sarcoid findings on FDG PET-CT using a 72-hour pretest high-fat, high-protein, and very low-carbohydrate (HFHPVLC) diet.
Patients and methods
A total of 196 consecutive FDG PET-CT scans with 72-hour HFHPVLC diet preparation were performed between December 2014 and December 2015 in known sarcoid patients. Of these scans, 5 were excluded for non-adherence to diet preparation or underlying cancer. Cardiac and extra-thoracic sarcoid lesions were categorized and measured for radiotracer uptake.
A total of 188 patients had 191 eligible FDG PET/CT scans (3 follow-up scans), of which there were 20 (10%) positive, 6 indeterminate (3%), and 165 (86%) negative for CS. Among the 20 scans positive for CS, 8 (40%) had findings of both cardiac and extra-thoracic sarcoid.
Our study shows that 40% of CS patients also have FDG PET-CT findings of extra-thoracic sarcoid. This makes an intriguing case for FDG PET-CT use with pretest diet prep over cardiac MRI (CMR) for cardiac sarcoid evaluation, given that CMR is likely to overlook these extra-thoracic sites of disease.
KeywordsCardiac Extra-thoracic Sarcoid Sarcoidosis FDG PET-CT
High-fat, high-protein, and very low-carbohydrate
Institutional review board
All the authors, Darshan C. Patel, Senthil S. Gunasekaran, Christopher Goettl, Nadera J. Sweiss, and Yang Lu, state that they have nothing to disclose.
- 4.Cooper LT, Baughman KL, Feldman AM, Frustaci A, Jessup M, Kuhl U, et al. The role of endomyocardial biopsy in the management of cardiovascular disease: A scientific statement from the American Heart Association, the American College of Cardiology, and the European Society of Cardiology. Endorsed by the Heart Failure Society of America and the Heart Failure Association of the European Society of Cardiology. J Am Coll Cardiol 2007;50:1914-31.CrossRefGoogle Scholar
- 6.Hulten E, Aslam S, Osborne M, Abbasi S, Bittencourt MS, Blankstein R. Cardiac sarcoidosis-state of the art review. Cardiovasc Diagn Ther 2016;6:50-63.Google Scholar
- 14.Okumura W, Iwasaki T, Toyama T, Iso T, Arai M, Oriuchi N, et al. Usefulness of fasting 18F-FDG PET in identification of cardiac sarcoidosis. J Nucl Med 2004;45:1989-98.Google Scholar
- 22.Rose AS, Tielker MA, Knox KS. Hepatic, ocular, and cutaneous sarcoidosis. Clin Chest Med 2008;29:509-24, ix.Google Scholar
- 23.Singh G, Sangolli P, Dash K, Grove S. Cutaneous sarcoidosis without systemic involvement. Indian J Dermatol Venereol Leprol 2000;66:43-4.Google Scholar
- 24.Okamoto H, Mizuno K, Ohtoshi E. Cutaneous sarcoidosis with cardiac involvement. Eur J Dermatol 1999;9:466-9.Google Scholar
- 29.CerfPayrastre I, Liote F. Bone, joint, and muscle involvement in sarcoidosis. Sem Hop Paris 1997;73:945-52.Google Scholar
- 31.James DG, Sharma OP. Extrathoracic sarcoidosis. Proc R Soc Med 1967;60:992-4.Google Scholar
- 36.Gropler RJ, Siegel BA, Lee KJ, Moerlein SM, Perry DJ, Bergmann SR, et al. Nonuniformity in myocardial accumulation of fluorine-18-fluorodeoxyglucose in normal fasted humans. J Nucl Med 1990;31:1749-56.Google Scholar