Feasibility of 18 FDG PET in the cardiac inflammation
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ORIGINAL PAPER
Feasibility of 18FDG PET in the cardiac inflammation Sebastian Osiecki1,2 · Maciej Sterliński3 · Marta Marciniak‑Emmons3 · Mirosław Dziuk1,2 Received: 19 June 2020 / Accepted: 5 October 2020 © The Author(s) 2020
Abstract The aim of the study was to assess the feasibility of 18FDG PET in cardiac inflammation with a particular focus on the delayed scan. Thirty-five consecutive 18FDG PET scans of patients with suspected or confirmed cardiac inflammation were retrospectively reviewed. The patients were referred for PET because of endocarditis (n = 16) or sarcoidosis (n = 19). Among them four patients had two consecutive for follow up and treatment control (two patients with sarcoidosis, two with endocarditis). In all of the cases a standard head to mid-thigh scan was performed 45–60 min after 18FDG injection as well as a delayed heart scan 1 h after the standard imaging was performed. 18FDG PET confirmed active inflammation in 10 out of 35 scans. Delayed scans in positive cases showed SUVmax value increase, but did not have an impact on the result, neither they did in negative cases—no significant differences between standard and delayed scan were found. Interestingly in 5 out of 14 cases with suspected endocarditis PET revealed the extracardiac inflammation focus, thus changing initial diagnosis. 18 FDG PET also indicated which prosthesis caused inflammation if there were many. In the sarcoidosis group the aim was to confirm or exclude heart involvement (13 scans) or to assess the response to the steroid therapy (6 scans) in patients with previously confirmed sarcoidosis. PET revealed active heart disease in 3 initial scans, and 1 follow up scan. 18FDG PET is a valuable imaging method for the cardiac inflammation assessment. It adequately localises the active inflammation site. Also, since it is a whole-body scan it may detect the extracardiac inflammation foci, which in some cases may change the initial diagnosis. In our study the delayed scans showed no added value. Keywords Endocarditis · Sarcoidosis · Positron emission tomography · Fluorodeoxyglucose · Nuclear imaging
Introduction Nowadays the 18FDG PET (fluorodeoxyglucose positron emission tomography) imaging is most often used for oncology imaging. However, it is also a valuable tool for inflammation evaluation. This work focuses on cardiac inflammation: infective endocarditis or sarcoidosis. Sarcoidosis is a rare granulomatous disease which affects mainly the lungs and the mediastinal lymph nodes. Heart involvement is seen in 5 to 25% of cases, less frequently in the Caucasians and more frequently in the Asians [1, 2] * Sebastian Osiecki [email protected] 1
Department of Nuclear Medicine, Military Institute of Medicine, 128 Szaserów St, 04‑141 Warsaw, Poland
2
Affidea Mazovian PET/CT Medical Centre, 128 Szaserów St, 04‑349 Warsaw, Poland
3
Cardinal Wyszynski National Institute of Cardiology, Warsaw, Poland
Cardiac sarcoidosis symptoms depend on the disease extent and may vary from asymptomatic to severe arrhythmias and heart
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