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Diagnostic value of quantitative assessment of cardiac 18F-fluoro-2-deoxyglucose uptake in suspected cardiac sarcoidosis

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Abstract

Objective

The identification of cardiac sarcoidosis is challenging as there is no gold standard consensually admitted for its diagnosis. The aim of this study was to evaluate the diagnostic value of the assessment of cardiac dynamic 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET/CT) and net influx constant (Ki) in patients suspected of cardiac sarcoidosis.

Methods

Data obtained from 30 biopsy-proven sarcoidosis patients suspected of cardiac sarcoidosis who underwent a 50-min list-mode cardiac dynamic 18F-FDG PET/CT after a 24 h high-fat and low-carbohydrate diet were analyzed. A normalized coefficient of variation of quantitative glucose influx constant, calculated as the ratio: standard deviation of the segmental Ki (min−1)/global Ki (min−1) was determined using a validated software (Carimas® 2.4, Turku PET Centre). Cardiac sarcoidosis was diagnosed according to the Japanese Ministry of Health and Welfare criteria. Receiving operating curve analysis was performed to determine sensitivity and specificity of cardiac dynamic 18F-FDG PET/CT analysis to diagnose cardiac sarcoidosis.

Results

Six out of 30 patients (20%) were diagnosed as having cardiac sarcoidosis. Myocardial glucose metabolism was significantly heterogeneous in patients with cardiac sarcoidosis who showed significantly higher normalized coefficient of variation values compared to patients without cardiac sarcoidosis (0.513 ± 0.175 vs. 0.205 ± 0.081; p = 0.0007). Using ROC curve analysis, we found a cut-off value of 0.38 for the diagnosis of cardiac sarcoidosis with a sensitivity of 100% and a specificity of 91%.

Conclusions

Our results suggest that quantitative analysis of cardiac dynamic 18F-FDG PET/CT could be a useful tool for the diagnosis of cardiac sarcoidosis.

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Abbreviations

ACE:

Angiotensin-converting enzyme

CRP:

C-reactive protein

CS:

Cardiac sarcoidosis

CT:

Computed tomography

FFA:

Free fatty acids

18F-FDG:

8F-fluoro-2-deoxyglucose

18F-FDG PET/CT:

Cardiac dynamic 18F-fluoro-2-deoxyglucose positron emission tomography

FWHM:

Full width at half maximum

HFLC:

High-fat and low-carbohydrate

Ki:

Net influx constant

MPI:

Myocardial perfusion imaging

NCOV:

Normalized coefficient of variation

PET:

Positron emission tomography

ROC:

Receiving operating curve

ROI:

Region of interest

SUV:

Standard uptake value

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Acknowledgements

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

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Authors and Affiliations

  1. Department of Nuclear Medicine, CHU de Caen, 14000, Caen, France

    Adrien Lebasnier, Cédric Desmonts, Denis Agostini & Alain Manrique

  2. Normandie Université, UNICAEN, EA4650 Signalisation, Électrophysiologie et Imagerie des Lésions d’Ischémie-Reperfusion Myocardique, 14000, Caen, France

    Damien Legallois, Denis Agostini & Alain Manrique

  3. Department of Cardiology, CHU de Caen, 14000, Caen, France

    Damien Legallois

  4. Department of Internal Medicine, CHU de Caen, 14000, Caen, France

    Boris Bienvenu

  5. Department of Pulmonary Medicine, CHU de Caen, 14000, Caen, France

    Emmanuel Bergot & Gérard Zalcman

  6. Cyceron PET Centre, 14000, Caen, France

    Alain Manrique

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  1. Adrien Lebasnier
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Correspondence to Alain Manrique.

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Lebasnier, A., Legallois, D., Bienvenu, B. et al. Diagnostic value of quantitative assessment of cardiac 18F-fluoro-2-deoxyglucose uptake in suspected cardiac sarcoidosis. Ann Nucl Med 32, 319–327 (2018). https://doi.org/10.1007/s12149-018-1250-3

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  • DOI: https://doi.org/10.1007/s12149-018-1250-3

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