Author + information
- Received May 19, 2010
- Revision received September 30, 2010
- Accepted September 30, 2010
- Published online December 1, 2010.
- Nobuhiro Tahara, MD, PhD⁎,⁎ (, )
- Atsuko Tahara, MD⁎,
- Yoshikazu Nitta, MD⁎,
- Norihiro Kodama, MD⁎,
- Minori Mizoguchi, MD⁎,
- Hayato Kaida, MD, PhD†,
- Kenkichi Baba, MD†,
- Masatoshi Ishibashi, MD, PhD†,
- Naofumi Hayabuchi, MD, PhD†,
- Jagat Narula, MD, PhD‡ and
- Tsutomu Imaizumi, MD, PhD⁎
- ↵⁎Reprint requests and correspondence:
Dr. Nobuhiro Tahara, Department of Medicine, Division of Cardio-Vascular Medicine, Kurume University School of Medicine, 67 Asahi-machi, Kurume 830-0011, Japan
Objectives This study evaluated the usefulness of fasting 18F-fluorodeoxyglucose (FDG)–positron emission tomography (PET) in the diagnosis and management of cardiac sarcoidosis (CS) and compared it with FDG uptake in dilated cardiomyopathy (DCM).
Background Cardiac sarcoidosis may clinically present as DCM but is amenable to systemic corticosteroid therapy if disease activity is high. Although alterations of FDG uptake have been reported in CS, limited information is available on the quantitative estimates of FDG uptake.
Methods Fasting FDG–PET was performed in 24 systemic sarcoidosis patients and was compared with 8 age-matched DCM patients. FDG–PET was also performed in 15 age-matched healthy control subjects. Twelve of the 24 sarcoidosis patients had cardiac involvement based on criteria established by the Japanese Ministry of Health and Welfare; the remaining 12 of 24 patients revealed no evidence of cardiac involvement. The myocardial FDG uptake was quantified by measuring the standardized uptake value in 17 myocardial segments in each subject. Coefficient of variation (COV), which equals the standard deviation of uptake divided by the average uptake of 17 segments, was calculated as an index of heterogeneity in the heart.
Results The FDG uptake was distinctly heterogeneous in CS patients. The COV value was significantly greater in CS patients (0.25 ± 0.05) than control subjects (0.14 ± 0.03, p < 0.01), sarcoidosis patients without cardiac involvement (0.14 ± 0.03, p < 0.01), or DCM patients (0.15 ± 0.02, p < 0.01). The COV value in DCM patients was similar to control subjects or sarcoidosis patients without cardiac involvement. The cutoff COV value for the diagnosis of CS was 0.18 (sensitivity: 100%; specificity: 97%). After corticosteroid therapy in CS patients, the COV value was decreased to 0.14 ± 0.06 (p < 0.05) and became essentially similar to the other groups.
Conclusions Heterogeneous myocardial FDG uptake may be a useful diagnostic marker of disease activity for CS.
- cardiac sarcoidosis
- dilated cardiomyopathy
- 18F-fluorodeoxyglucose–positron emission tomography
The authors have reported that they have no relationships to disclose. H. William Strauss, MD, served as Guest Editor for this article.
- Received May 19, 2010.
- Revision received September 30, 2010.
- Accepted September 30, 2010.
- American College of Cardiology Foundation