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Diagnostic yield of whole-body 18F-FDG PET/CT in patients with suspected cardiac sarcoidosis

  • ORIGINAL ARTICLE
  • Published:
Journal of Nuclear Cardiology Aims and scope

Abstract

Background

Whole-body F-18 FDG PET has been included in the 2014 Heart Rhythm Society guidelines for cardiac sarcoidosis evaluation to identify alternate sites of biopsy prior to endomyocardial biopsy. The purpose of this study was to evaluate the diagnostic yield of whole-body F-18 FDG PET/CT.

Methods

All adult patients with suspected cardiac sarcoidosis undergoing same-day cardiac F-18 FDG PET/CT and whole-body F-18 FDG PET/CT between 10/1/2016 and 6/14/2021 to assess potential biopsy sites were retrospectively identified. Clinical indications, findings, recommendations, and outcomes were assessed.

Results

Eighty-eight patients were included. Extracardiac PET findings suggestive of sarcoidosis were present in 30 patients (34%), 27 of which had thoracic findings (90%). Sarcoidosis was diagnosed in 11% of patients. Only 1% (1/88) was diagnosed by extrathoracic biopsy of a whole-body PET finding. Incidental findings were common (31%), resulting in 11 additional tests or interventions. Recommendations from extrathoracic findings affected treatment in one case: a drainage catheter placement into an unsuspected pelvic abscess.

Conclusion

Addition of whole-body F-18 FDG PET/CT to cardiac F-18 FDG PET/CT for the identification of extrathoracic sites of biopsy in patients with suspected cardiac sarcoidosis has marginal diagnostic yield but commonly results in incidental findings that rarely affect patient outcome.

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Abbreviations

F-18 FDG PET:

18F-fluorodeoxyglucose positron emission tomography

MRI:

Magnetic Resonance Imaging

CT:

Computerized Tomography

HIPAA:

Health Insurance Portability and Accountability Act

STROBE:

Strengthening the Reporting of Observational Studies in Epidemiology

NPO:

Non per os

EF:

Ejection fraction

SUVmax :

Standardized uptake value

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Acknowledgements

We acknowledge Sarah Abate and Danielle Dobbs for their help in creating the visual abstract for this manuscript.

Author contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JKS, KAF, DB, and MSD. The first draft of the manuscript was written by JKS and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Ethical approval

This retrospective chart review study involving human participants was in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. The Human Investigation Committee (IRB) of University of Michigan approved this study.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA

    Jamal K. Saleh MD, Daniel Barkmeier MD, PhD, Kirk A. Frey MD, PhD & Matthew S. Davenport MD

  2. Department of Urology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA

    Matthew S. Davenport MD

  3. Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1H4, Canada

    Jamal K. Saleh MD

Authors
  1. Jamal K. Saleh MD
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  2. Daniel Barkmeier MD, PhD
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  3. Kirk A. Frey MD, PhD
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  4. Matthew S. Davenport MD
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Corresponding author

Correspondence to Jamal K. Saleh MD.

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Funding

No funding was received to assist with the preparation of this manuscript. Dr Davenport has received unrelated royalties from Wolters Kluwer and UpToDate.com. Jamal K. Saleh, Kirk A. Frey, and Daniel Barkmeier declare that no funds, grants, or other support were received during the preparation of this manuscript. The authors have no relevant financial or non-financial interests to disclose.

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Saleh, J.K., Barkmeier, D., Frey, K.A. et al. Diagnostic yield of whole-body 18F-FDG PET/CT in patients with suspected cardiac sarcoidosis. J. Nucl. Cardiol. 30, 1773–1781 (2023). https://doi.org/10.1007/s12350-023-03222-6

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  • DOI: https://doi.org/10.1007/s12350-023-03222-6

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