18F-FDG uptake of the right ventricle is an important predictor of histopathologic diagnosis by endomyocardial biopsy in patients with cardiac sarcoidosis

  • Kazunori Omote
  • Masanao NayaEmail author
  • Kazuhiro Koyanagawa
  • Tadao Aikawa
  • Osamu Manabe
  • Toshiyuki Nagai
  • Kiwamu Kamiya
  • Yoshiya Kato
  • Hirokazu Komoriyama
  • Masato Kuzume
  • Nagara Tamaki
  • Toshihisa Anzai
Original Article



The aim of this study was to determine whether right ventricle (RV) 18F-fluorodeoxyglucose (FDG) uptake can predict positive findings of endomyocardial biopsy (EMB) in patients with cardiac sarcoidosis (CS).


70 consecutive patients with clinically diagnosed CS who had undergone FDG PET were registered in the present study. Patients without EMB (n = 42) were excluded. Ultimately, 28 patients were studied. EMB samples were obtained from the RV septum. We evaluated the FDG uptake on six segments (RV, left ventricle anterior, septal, lateral, inferior, and apex).


Positive EMB was found in six patients (21%). Patients were divided into two groups according to positive (n = 12 [43%]) or negative (n = 16 [57%]) RV FDG uptake. Patients with positive RV FDG uptake had a significantly higher frequency of positive EMB than those without (42% vs. 6%, P = 0.024). On the other hand, there was no EMB-predictive value for the FDG uptakes in the other five segments, the cardiac metabolic volume, total lesion glycolysis, left ventricular ejection fraction, or any electrocardiogram findings.


FDG uptake of the RV but no other heart segment was associated with positive EMB in CS patients. The presence of RV FDG uptake could improve the rate of positive EMB up to 42% in patients with CS.


Cardiac sarcoidosis endomyocardial biopsy 18F-fluorodeoxyglucose positron emission tomography right ventricle 



Cardiac metabolic volume


Cardiac sarcoidosis


Endomyocardial biopsy




Left ventricle


Left ventricular ejection fraction


Positron emission tomography


Right ventricle


Standardized uptake value


Total lesion glycolysis



The authors are grateful to Dr Tomoko Mitsuhashi and Dr Ken Kuwahara for their support with the histologic evaluation. The authors are also grateful to Kota Ohno, PhD, for statistical support.


The authors declare that they have no conflict of interest.

Supplementary material

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Copyright information

© American Society of Nuclear Cardiology 2019

Authors and Affiliations

  • Kazunori Omote
    • 1
  • Masanao Naya
    • 1
    Email author
  • Kazuhiro Koyanagawa
    • 1
  • Tadao Aikawa
    • 1
  • Osamu Manabe
    • 2
  • Toshiyuki Nagai
    • 1
  • Kiwamu Kamiya
    • 1
  • Yoshiya Kato
    • 1
  • Hirokazu Komoriyama
    • 1
  • Masato Kuzume
    • 1
  • Nagara Tamaki
    • 3
  • Toshihisa Anzai
    • 1
  1. 1.Department of Cardiovascular MedicineHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Department of Nuclear MedicineHokkaido University Graduate School of MedicineSapporoJapan
  3. 3.Department of RadiologyKyoto Prefectural University of MedicineKyotoJapan

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