title: Somatostatin receptor based PET/CT in patients with the suspicion of cardiac sarcoidosis: an initial comparison to cardiac MRI.
abstract: Diagnosis of cardiac sarcoidosis is often challenging. Whereas cardiac magnetic resonance imaging (CMR) and positron emission tomography/computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) are most commonly used to evaluate patients, PET/CT using radiolabeled somatostatin receptor (SSTR) ligands for visualization of inflammation might represent a more specific alternative. This study aimed to investigate the feasibility of SSTR-PET/CT for detecting cardiac sarcoidosis in comparison to CMR.15 patients (6 males, 9 females) with sarcoidosis and suspicion on cardiac involvement underwent SSTR-PET/CT imaging and CMR. Images were visually scored. The AHA 17-segment model of the left myocardium was used for localization and comparison of inflamed myocardium for both imaging modalities. In semi-quantitative analysis, mean (SUVmean) and maximum standardized uptake values (SUVmax) of affected myocardium were calculated and compared with both remote myocardium and left ventricular (LV) cavity.SSTR-PET was positive in 7/15, CMR in 10/15 patients. Of the 3 CMR+/PET- subjects, one patient with minor involvement (<25% of wall thickness in CMR) was missed by PET. The remaining two CMR+/PET- patients displayed no adverse cardiac events during follow-up.In the 17-segment model, PET/CT yielded 27 and CMR 29 positive segments. Overall concordance of the 2 modalities was 96.1% (245/255 segments analyzed). SUVmean and SUVmax in inflamed areas were 2.0±1.2 and 2.6±1.2, respectively. The lesion-to-remote myocardium and lesion-to-LV cavity ratios were 1.8±0.2 and 1.9±0.2 for SUVmean and 2.0±0.3 and 1.7±0.3 for SUVmax, respectively.Detection of cardiac sarcoidosis by SSTR-PET/CT is feasible. Our data warrant further analysis in larger prospective series.
authors: Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors: Constantin
authors: C
authors: Lapa
authors: Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Würzburg, Würzburg, Germany.
authors: Theresa
authors: T
authors: Reiter
authors: Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors: Malte
authors: M
authors: Kircher
authors: Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors: Andreas
authors: A
authors: Schirbel
authors: Department of Nuclear Medicine, University Hospital Würzburg, Würzburg, Germany.
authors: Rudolf A
authors: RA
authors: Werner
authors: Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany.
authors: Theo
authors: T
authors: Pelzer
authors: Department of Internal Medicine II - Pneumology/Cardiology, University Hospital Bonn, Bonn, Germany.
authors: Carmen
authors: C
authors: Pizarro
authors: Department of Internal Medicine II - Pneumology/Cardiology, University Hospital Bonn, Bonn, Germany.
authors: Dirk
authors: D
authors: Skowasch
authors: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors: Lena
authors: L
authors: Thomas
authors: Department of Radiology, University Hospital Bonn, Bonn, Germany.
authors: Ulrike
authors: U
authors: Schlesinger-Irsch
authors: Department of Radiology, University Hospital Bonn, Bonn, Germany.
authors: Daniel
authors: D
authors: Thomas
authors: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors: Ralph A
authors: RA
authors: Bundschuh
authors: Department of Internal Medicine, University Hospital Würzburg, Würzburg, Germany.|Comprehensive Heart Failure Center, University Würzburg, Würzburg, Germany.
authors: Wolfgang R
authors: WR
authors: Bauer
authors: Department of Nuclear Medicine, University Hospital Bonn, Bonn, Germany.
authors: Florian C
authors: FC
authors: Gärtner
mesh_terms: D000328:Adult; D000368:Aged; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000378:metabolism; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011446:Prospective Studies; D017481:Receptors, Somatostatin / Q000378:metabolism*; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000378:metabolism; D012680:Sensitivity and Specificity
chemical_list: D017481:Receptors, Somatostatin
keywords: DOTATOC; PET; SSTR; sarcoidosis; somatostatin receptor