title: Comparison of (18)F-fluorodeoxyglucose positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) in corticosteroid-naive patients with conduction system disease due to cardiac sarcoidosis.
abstract: OBJECTIVE
  Cardiac sarcoidosis (CS) is a cause of conduction system disease (CSD). (18)F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population.
  
  
  METHODS
  We recruited steroid-naive patients with newly diagnosed CSD due to CS. All CS patients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups: group A with chronic mild CSD (right bundle branch block and/or axis deviation), and group B with new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB).
  
  
  RESULTS
  Thirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p = 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 - 34.3, vs. 72.0, IQR 25.0 - 79.5 days; p = 0.03).
  
  
  CONCLUSIONS
  The number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS.
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: David H
authors.initials: DH
authors.lastname: Birnie
authors.affiliation: Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada.|Department of Radiology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Elena
authors.initials: E
authors.lastname: Pena
authors.affiliation: Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Jordan
authors.initials: J
authors.lastname: Bernick
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Brian
authors.initials: B
authors.lastname: Mc Ardle
authors.affiliation: Division of Nuclear Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Eugene
authors.initials: E
authors.lastname: Leung
authors.affiliation: Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: George A
authors.initials: GA
authors.lastname: Wells
authors.affiliation: Department of Molecular Imaging, Hokkaido University School of Medicine, Hokkaido, Japan.
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoshinaga
authors.affiliation: First Department of Medicine, Hokkaido University school of Medicine, Hokkaido, Japan.
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.affiliation: First Department of Medicine, Hokkaido University school of Medicine, Hokkaido, Japan.
authors.forename: Takahiro
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Nuclear Medicine, Hokkaido University School of Medicine, Hokkaido, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Manabe
authors.affiliation: Diagnostic and Interventional Radiology, Hokkaido University Hospital, Hokkaido, Japan.
authors.forename: Noriko
authors.initials: N
authors.lastname: Oyama-Manabe
authors.affiliation: First Department of Medicine, Hokkaido University school of Medicine, Hokkaido, Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Nishimura
authors.affiliation: Department of Nuclear Medicine, Hokkaido University School of Medicine, Hokkaido, Japan.
authors.forename: Nagara
authors.initials: N
authors.lastname: Tamaki
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Alexander
authors.initials: A
authors.lastname: Dick
authors.affiliation: Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada.|Department of Radiology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Carole
authors.initials: C
authors.lastname: Dennie
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Ran
authors.initials: R
authors.lastname: Klein
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Renaud
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Robert A
authors.initials: RA
authors.lastname: deKemp
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.|Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada.|Department of Radiology, University of Ottawa, Ottawa, ON, Canada.|Division of Nuclear Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Terrence D
authors.initials: TD
authors.lastname: Ruddy
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.|Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada.|Department of Radiology, University of Ottawa, Ottawa, ON, Canada.
authors.forename: Benjamin J W
authors.initials: BJW
authors.lastname: Chow
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Ross
authors.initials: R
authors.lastname: Davies
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Renee
authors.initials: R
authors.lastname: Hessian
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.
authors.forename: Peter
authors.initials: P
authors.lastname: Liu
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada.|Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada.|Department of Radiology, University of Ottawa, Ottawa, ON, Canada.|Division of Nuclear Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada.
authors.forename: Rob S B
authors.initials: RSB
authors.lastname: Beanlands
authors.affiliation: Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7. PNery@ottawaheart.ca.|Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada. PNery@ottawaheart.ca.
authors.forename: Pablo B
authors.initials: PB
authors.lastname: Nery
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D006329:Heart Conduction System / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-Fluorodeoxyglucose positron emission tomography; Atrioventricular block; Cardiac magnetic resonance; Cardiac sarcoidosis; Conduction system disease