title: Right ventricular (18)F-FDG uptake is an important indicator for cardiac involvement in patients with suspected cardiac sarcoidosis.
abstract: OBJECTIVE
  Cardiac sarcoidosis is most commonly found in the left ventricular (LV) free wall. Presence in the right ventricle (RV) is less common but might be useful for detecting cardiac involvement of sarcoidosis. (18)F-fluorodeoxyglucose ((18)F-FDG) PET has been used to detect LV regions with cardiac sarcoidosis. However, the same has not been done for RV involvement. The aims of the current study were to evaluate RV (18)F-FDG uptake and its relationship to the distribution of LV wall (18)F-FDG-positive segments in the LV, and to evaluate whether patients with positive RV (18)F-FDG uptake met the 1993 diagnostic criteria of the Japanese Ministry of Health and Welfare (JMHW) guidelines regarding sarcoidosis with suspected cardiac involvement.
  
  
  METHODS
  Fifty-nine biopsy-proven extra-cardiac sarcoidosis patients (age 56.1 ± 14.7 years) with suspected cardiac involvement based on abnormal electrocardiography or echocardiography findings underwent fasting (18)F-FDG PET or PET/CT. The LV wall was divided into 17 segments and RV uptake was also evaluated.
  
  
  RESULTS
  Among 59 patients, 35 (59.3%) showed some abnormal (18)F-FDG uptake in the RV and/or LV wall. With respect to the RV wall, 13 (22.0%) showed abnormal (18)F-FDG uptake. The number of LV-involved segments was 4.8 ± 2.4 in the patients with RV (18)F-FDG uptake, which was significantly higher than in the patients without RV uptake, 1.8 ± 2.2 (P < 0.0001). Patients with RV uptake more frequently met the diagnostic criteria of the 1993 JMHW guidelines (n = 27), than did those without RV uptake (84.6 vs. 34.8%, P = 0.0033).
  
  
  CONCLUSIONS
  (18)F-FDG PET identified RV involvement less frequently than LV involvement in this study population. However, patients who had RV uptake showed a greater number of LV-involved segments and met the JMHW diagnostic criteria more frequently. Although RV uptake is less frequent, (18)F-FDG RV uptake may be useful in diagnosing cardiac involvement in sarcoidosis.
  
  
  BACKGROUND
  UMIN000006533.
authors.affiliation: Department of Nuclear Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Manabe
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoshinaga
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.forename: Asuka
authors.initials: A
authors.lastname: Yamada
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.forename: Atsuro
authors.initials: A
authors.lastname: Masuda
authors.forename: Keiichi
authors.initials: K
authors.lastname: Magota
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki
mesh_terms: D001692:Biological Transport; D009202:Cardiomyopathies / Q000175:diagnosis* / Q000378:metabolism*; D004562:Electrocardiography; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism*; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D012507:Sarcoidosis / Q000175:diagnosis* / Q000378:metabolism*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography
chemical_list: D019788:Fluorodeoxyglucose F18