title: Quantitative interpretation of FDG PET/CT with myocardial perfusion imaging increases diagnostic information in the evaluation of cardiac sarcoidosis.
abstract: BACKGROUND
  FDG PET/CT with myocardial perfusion imaging is a useful method for evaluating cardiac sarcoidosis (CS), but interpretation is not standardized. We developed a method for quantification of cardiac FDG PET/CT and evaluated its relationship to conventional interpretation, perfusion defects, clinical events, and immunosuppressive treatment.
  
  
  RESULTS
  FDG PET/CT with MPI studies performed for CS (n = 38) were retrospectively compared to negative control studies acquired for oncologic indications (n = 10). Quantitative measures of FDG volume-intensity (Cardiac Metabolic Activity, CMA) was performed using standardized uptake values (SUVs). CMA (477.7 ± 909 vs 0.55 ± 2.1 vs 0.3 ± 0.3 g glucose, P = .02) was significantly greater in visually FDG-positive studies compared to visually negative and oncologic negative studies. Among patients with CS, CMA was greater in studies with an EF < 50% (760.3 ± 1,148 vs 87.4 ± 161 g glucose, P = .03) and preceding an adverse clinical event (1,095 ± 1,253 vs 73 ± 144 g glucose, P = .006). CMA was the only independent predictor of events by multivariate analysis. In patients with repeat examinations (n = 7), CMA decreased with prednisone treatment in 5 of 6 patients.
  
  
  CONCLUSIONS
  Quantification of FDG uptake in CS correlates with lower EFs, clinical events, and immunosuppression treatment.
authors.affiliation: Section of Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Ahmadian
authors.forename: Ashley
authors.initials: A
authors.lastname: Brogan
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Berman
authors.forename: Aaron L
authors.initials: AL
authors.lastname: Sverdlov
authors.forename: Gustavo
authors.initials: G
authors.lastname: Mercier
authors.forename: Michael
authors.initials: M
authors.lastname: Mazzini
authors.forename: Praveen
authors.initials: P
authors.lastname: Govender
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Ruberg
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Miller
mesh_terms: D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006331:Heart Diseases / Q000175:diagnosis* / Q000378:metabolism; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging / Q000379:methods; D055414:Myocardial Perfusion Imaging / Q000379:methods*; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000175:diagnosis* / Q000378:metabolism; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18