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The prognostic value of quantitating and localizing F-18 FDG uptake in cardiac sarcoidosis

Journal of Nuclear Cardiology volume 27, pages 2003–2010 (2020)Cite this article

Abstract

Background

There is no identified level of FDG uptake in cardiac sarcoidosis (CS) associated with increased risk of arrhythmias, conduction disease, heart failure, or death. We aim to utilize standardized uptake value (SUV) quantitation and localization to identify patients at increased risk of cardiac events.

Methods and Results

F18-FDG PET/CT with MPI was used in CS diagnosis (N = 67). Mean and max SUV were measured and grouped as basal, mid, and apical disease. Post-scan ventricular tachycardia, AICD placement, complete heart block, pacemaker placement, atrial fibrillation, heart failure, and cardiac-related hospital admissions were recorded (mean follow up 2.98 ± 2 years). Poisson regression analysis revealed that max SUV, mean SUV, as well as mean basal SUV, and LVEF were significantly associated with total cardiac events. Max SUV odds ratio (OR) = 1.068 (95% CI 1.024-1.114, P = 0.002), mean SUV OR = 1.059 (95% CI 1.008-1.113, P = 0.023), mean SUV OR = 1.061 (95% CI 1.012-1.112, P = 0.014), scan LVEF OR = 0.731 (95% CI 0.664-0.805, P < 0.001).

Conclusions

SUV at time of CS diagnosis has significant associations with future cardiac events. Patients with higher SUV, particularly in basal segments, are at increased risk of events. Further studies are needed to identify treatment methods utilizing risk stratification of CS.

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Abbreviations

F18:

Flourine 18

FDG:

Fluorodeoxyglucose

MPI:

Myocardial perfusion imaging

CS:

Cardiac Sarcoidosis

SUV:

Standardized Uptake Value

VT:

Ventricular Tachycardia

AICD:

Automatic Implantable Cardiac Defibrillator

CHB:

Complete Heart block

PPM:

Permanent Pacemaker

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Disclosures

The authors declare that they do not have any conflicts of interest to disclose.

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Affiliations

  1. Internal Medicine, Columbia University Medical Center, New York, NY, USA

    R. J. Flores MD

  2. Internal Medicine, Division of Cardiology, Columbia University Medical Center, New York, NY, USA

    K. R. Flaherty BA & S. Bokhari MD

  3. Department of Biostatistics, Columbia University, New York, NY, USA

    Z. Jin PhD

Authors
  1. R. J. Flores MD
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  2. K. R. Flaherty BA
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  3. Z. Jin PhD
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  4. S. Bokhari MD
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Corresponding author

Correspondence to R. J. Flores MD.

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Flores, R.J., Flaherty, K.R., Jin, Z. et al. The prognostic value of quantitating and localizing F-18 FDG uptake in cardiac sarcoidosis. J. Nucl. Cardiol. 27, 2003–2010 (2020). https://doi.org/10.1007/s12350-018-01504-y

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  • DOI: https://doi.org/10.1007/s12350-018-01504-y

Keywords

  • Sarcoid heart diseases
  • PET
  • image analysis
  • diagnostic and prognostic application
  • inflammation
  • statistical analysis