Feasibility of FDG-PET in myocarditis: Comparison to CMR using integrated PET/MRI

Feasibility of FDG-PET in myocarditis: Comparison to CMR using integrated PET/MRI

Besides cardiac sarcoidosis, FDG-PET is rarely used in the diagnosis of myocardial inflammation, while cardiac MRI (CMR) is the actual imaging reference for the workup of myocarditis. Using integrated PET/MRI in patients with suspected myocarditis, we prospectively compared FDG-PET to CMR and the fe...

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Bibliographic Details
Published in:Journal of nuclear cardiology Vol. 25; no. 3; pp. 785 - 794
Main Authors: Nensa, Felix, Kloth, Julia, Tezgah, Ercan, Poeppel, Thorsten D., Heusch, Philipp, Goebel, Juliane, Nassenstein, Kai, Schlosser, Thomas
Format: Journal Article
Language:English
Published: New York Elsevier Inc 01-06-2018
Springer US
Springer Nature B.V
Subjects:
Adult
Agreements
Cardiology
cardiovascular magnetic
Contrast Media
Feasibility Studies
Female
Fluorodeoxyglucose (FDG)
Fluorodeoxyglucose F18
Gadolinium
Humans
Imaging
Magnetic Resonance Imaging
Male
Medicine
Medicine & Public Health
Multimodal Imaging
myocarditis
Myocarditis - diagnostic imaging
Nuclear Medicine
Original Article
PET imaging
PET/MR imaging
Positron-Emission Tomography
Prospective Studies
Radiology
Radiopharmaceuticals
resonance imaging
EGE
PET imaging
MRI
TBR
myocarditis
FDG
resonance imaging
PET/MR imaging
CMR
LGE
ROI
SUV
EMB
Fluorodeoxyglucose (FDG)
PET
cardiovascular magnetic
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Summary:Besides cardiac sarcoidosis, FDG-PET is rarely used in the diagnosis of myocardial inflammation, while cardiac MRI (CMR) is the actual imaging reference for the workup of myocarditis. Using integrated PET/MRI in patients with suspected myocarditis, we prospectively compared FDG-PET to CMR and the feasibility of integrated FDG-PET/MRI in myocarditis. A total of 65 consecutive patients with suspected myocarditis were prospectively assessed using integrated cardiac FDG-PET/MRI. Studies comprised T2-weighted imaging, late gadolinium enhancement (LGE), and simultaneous PET acquisition. Physiological glucose uptake in the myocardium was suppressed using dietary preparation. FDG-PET/MRI was successful in 55 of 65 enrolled patients: two patients were excluded due to claustrophobia and eight patients due to failed inhibition of myocardial glucose uptake. Compared with CMR (LGE and/or T2), sensitivity and specificity of PET was 74% and 97%. Overall spatial agreement between PET and CMR was κ = 0.73. Spatial agreement between PET and T2 (κ = 0.75) was higher than agreement between PET and LGE (κ = 0.64) as well as between LGE and T2 (κ = 0.56). In patients with suspected myocarditis, FDG-PET is in good agreement with CMR findings.
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ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-016-0616-y