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European Heart Journal Advance Access originally published online on April 4, 2005
European Heart Journal 2005 26(15):1538-1543; doi:10.1093/eurheartj/ehi180
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© The European Society of Cardiology 2005. All rights reserved. For Permissions, please e-mail: journals.permissions@oupjournals.org

Focal uptake on 18F-fluoro-2-deoxyglucose positron emission tomography images indicates cardiac involvement of sarcoidosis{dagger}

Shinji Ishimaru1, Ichizo Tsujino1,*, Toshiki Takei2, Eriko Tsukamoto2, Shinji Sakaue1, Mitsunori Kamigaki1, Naofumi Ito1, Hiroshi Ohira1, Daisuke Ikeda1, Nagara Tamaki2 and Masaharu Nishimura1

1First Department of Medicine, Hokkaido University School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan
2Department of Nuclear Medicine, Hokkaido University School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan

Received 23 June 2004; revised 16 November 2004; accepted 27 January 2005; online publish-ahead-of-print 4 April 2005.

* Corresponding author. Tel: +81 11 706 5911; fax: +81 11 706 7899. E-mail address: it013{at}med.hokudai.ac.jp

Aims To evaluate the value of 18F-fluoro-2-deoxyglucose positron emission tomography (18F-FDG PET) in detecting cardiac sarcoidosis.

Methods and results Thirty-two patients with sarcoidosis and thirty controls were recruited. All subjects underwent cardiac 18F-FDG PET after a 6 h fasting period, and subjects with sarcoidosis underwent blood testing, ECG, echocardiography, and 67Ga and 99mTc-sestamibi (MIBI) scintigraphy. We classified 18F-FDG PET images into four patterns (‘none’, ‘diffuse’, ‘focal’, and ‘focal on diffuse’) and found that all the control subjects exhibited either none (n=16) or diffuse (n=14) pattern. In contrast, fifteen subjects with sarcoidosis exhibited none, seven exhibited diffuse, eight exhibited focal, and two exhibited focal on diffuse patterns, with the prevalence of the focal and focal on diffuse patterns being significantly higher in the sarcoidosis group when compared with the control group (P<0.001). None of the 32 subjects with sarcoidosis exhibited abnormal findings on 67Ga scintigraphy, and 4 exhibited abnormal findings on 99mTc-MIBI scintigraphy.

Conclusion Focal uptake of the heart on 18F-FDG PET images is a characteristic feature of patients with sarcoidosis. Furthermore, 18F-FDG PET has the potential to detect cardiac sarcoidosis that cannot be diagnosed by 67Ga or 99mTc-MIBI scintigraphy.

Key Words: 18F-FDG PET • 67Ga scintigraphy • 99mTc-sestamibi scintigraphy • Sarcoidosis • Heart


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