title: Diagnosis and Detection of Myocardial Injury in Active Cardiac Sarcoidosis--Significance of Myocardial Fatty Acid Metabolism and Myocardial Perfusion Mismatch.
abstract: BACKGROUND
  Myocardial injury can be detected more sensitively using (123)I-radioiodinated 15-(p-iodophenyl)-3(R,S)-methylpentadecanoic acid (BMIPP) than thallium-201 (TL). The present study investigated whether (18)F-fluorodeoxyglucose-positron emission tomography (FDG-PET) uptake as an index of active inflammation in patients with cardiac sarcoidosis (CS) is associated with BMIPP and TL findings, and whether dual single-photon emission computed tomography (SPECT) can facilitate diagnosis of CS.
  
  
  RESULTS
  We retrospectively enrolled 52 consecutive patients with suspected CS who were assessed on FDG-PET/computed tomography (CT) and BMIPP/TL dual SPECT. The SPECT images were divided into 17 segments and then BMIPP and TL total defect scores (BMDS, TLDS) as well as mismatch scores (BMDS-TLDS: sumMS) were calculated. Maximum standardized uptake value (SUVmax) in the entire myocardium was obtained from FDG-PET/CT. SUVmax was much higher in patients with, than without CS (P<0.0001). BMDS was higher and sumMS much higher in CS (P<0.05 and P<0.0001, respectively). The sensitivity and specificity of sumMS to detect CS were 74% and 80%, respectively. SUVmax was not associated with either BMDS or sumMS in the patients with CS. On multivariate analysis, the combination of sumMS and SUVmax had greater prognostic significance compared with each parameter on its own.
  
  
  CONCLUSIONS
  BMIPP and TL dual-tracer mismatch is a useful finding to diagnose CS, and adds greater diagnostic value to SUVmax on FDG-PET/CT.
authors.affiliation: Department of Diagnostic Imaging and Nuclear Medicine, Tokyo Women's Medical University.
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Momose
authors.forename: Kenji
authors.initials: K
authors.lastname: Fukushima
authors.forename: Chisato
authors.initials: C
authors.lastname: Kondo
authors.forename: Naoki
authors.initials: N
authors.lastname: Serizawa
authors.forename: Atsushi
authors.initials: A
authors.lastname: Suzuki
authors.forename: Koichiro
authors.initials: K
authors.lastname: Abe
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
authors.forename: Shuji
authors.initials: S
authors.lastname: Sakai
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism; D005227:Fatty Acids / Q000008:administration & dosage / Q000378:metabolism*; D005260:Female; D006801:Humans; D007462:Iodobenzenes / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009206:Myocardium / Q000378:metabolism*; D049268:Positron-Emission Tomography; D011859:Radiography; D012507:Sarcoidosis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism
chemical_list: D005227:Fatty Acids; D007462:Iodobenzenes; C049338:iodofiltic acid