Diagnostic utility of fusion 18 F-fluorodeoxyglucose positron emission tomography/cardiac magnetic resonance imaging in
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Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan Division of Cardiology, Osaka Pref. Saiseikai Tondabayashi Hospital, Tondabayashi, Japan Division of Positron Emission Tomography, Institute of Advanced Clinical Medicine, Kindai University, Osakasayama, Japan Departments of Radiology, Kindai University Faculty of Medicine, Osakasayama, Japan Center for Cerebral and Cardiovascular Disease Information, National Cerebral and Cardiovascular Center, Suita, Japan
Received Jun 10, 2020; Revised Aug 6, 2020; accepted Aug 25, 2020 doi:10.1007/s12350-020-02359-y
Background. Although each 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) and cardiac magnetic resonance (CMR) imaging with late gadolinium enhancement (LGE) has been used to diagnose cardiac sarcoidosis (CS), active CS is still misdiagnosed. Methods. Active CS, diagnosed by PET alone, was defined as focal or focal on diffuse FDG uptake pattern. In fusion PET/CMR imaging, using a regional analysis with AHA 17-segment model, the patients were categorized into four groups: (1) PET2/LGE2, (2) PET1/LGE2, (3) PET1/LGE1, and (4) PET2/LGE1. PET1/LGE1 was defined as active CS. Results. 74 Patients with suspected CS were enrolled. Between PET alone and fusion PET/ CMR imaging, 20 cases had mismatch evaluations of active CS, and most had diffuse or focal on diffuse FDG uptake pattern on PET alone imaging. 40 Patients fulfilled the 2016 the Japanese Circulation Society diagnostic criteria for CS. The interobserver diagnostic agreement was excellent (j statistics 0.89) and the overall accuracy for diagnosing CS was 87.8% in fusion PET/CMR imaging, which were superior to those in PET alone imaging (0.57 and 82.4%, respectively). In a sub-analysis of diffuse and focal on diffuse patterns, the agreement (j statistics 0.86) and overall accuracy (81.8%) in fusion PET/CMR imaging were still better. Conclusions. Fusion PET/CMR imaging with regional analysis offered reliable and accurate diagnosis of CS, covering low diagnostic area by FDG-PET alone. (J Nucl Cardiol 2020) Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12350-020-02359-y) contains supplementary material, which is available to authorized users. Funding This work was supported by Grants from the Vehicle Racing Commemorative Foundation (Y.I.). Mana Okune and Masakazu Yasuda contributed equally to this work. The authors of this article have provided a PowerPoint file, available for download at SpringerLink, which summarises the contents of the paper and is free for re-use at meetings and presentations. Search for the article DOI on SpringerLink.com.
The authors have also provided an audio summary of the article, which is available to download as ESM, or to listen to via the JNC/ASNC Podcast. Reprint requests: Yoshitaka Iwanaga, MD, Division of Cardiology, Department of Internal Medicine, Kindai University Faculty of Medicine, Osakasayama, Japan; [email protected] 1071-3581/$34
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