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European Heart Journal Advance Access published online on April 4, 2005
European Heart Journal, doi:10.1093/eurheartj/ehi180
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European Heart Journal © The European Society of Cardiology 2005; all rights reserved
Received June 23, 2004
Revised November 16, 2004
Accepted January 27, 2005

Clinical research

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

Shinji Ishimaru 1, Ichizo Tsujino 1*, Toshiki Takei 2, Eriko Tsukamoto 2, Shinji Sakaue 1, Mitsunori Kamigaki 1, Naofumi Ito 1, Hiroshi Ohira 1, Daisuke Ikeda 1, Nagara Tamaki 2, and Masaharu Nishimura 1

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

* To whom correspondence should be addressed.
Ichizo Tsujino, E-mail: it013{at}med.hokudai.ac.jp


  Abstract

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.

Keywords: 18F-FDG PET; 67Ga scintigraphy; 99mTc-sestamibi scintigraphy; Sarcoidosis; Heart.
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