Hiroshi Ohira1,2, David H Birnie1,2, Elena Pena3,4, Jordan Bernick5, Brian Mc Ardle1,2, Eugene Leung6, George A Wells5, Keiichiro Yoshinaga7, Ichizo Tsujino8, Takahiro Sato8, Osamu Manabe9, Noriko Oyama-Manabe10, Masaharu Nishimura8, Nagara Tamaki9, Alexander Dick1,2, Carole Dennie3,4, Ran Klein1,2, Jennifer Renaud1,2, Robert A deKemp1,2, Terrence D Ruddy1,2,3,4,6, Benjamin J W Chow1,2,3,4, Ross Davies1,2, Renee Hessian1,2, Peter Liu1,2, Rob S B Beanlands1,2,3,4,6, Pablo B Nery11,12. 1. Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7. 2. Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada. 3. Medical Imaging Department, The Ottawa Hospital, Ottawa, ON, Canada. 4. Department of Radiology, University of Ottawa, Ottawa, ON, Canada. 5. Cardiovascular Research Methods Center, University of Ottawa Heart Institute, Ottawa, ON, Canada. 6. Division of Nuclear Medicine, Department of Medicine, The Ottawa Hospital, Ottawa, Ontario, Canada. 7. Department of Molecular Imaging, Hokkaido University School of Medicine, Hokkaido, Japan. 8. First Department of Medicine, Hokkaido University school of Medicine, Hokkaido, Japan. 9. Department of Nuclear Medicine, Hokkaido University School of Medicine, Hokkaido, Japan. 10. Diagnostic and Interventional Radiology, Hokkaido University Hospital, Hokkaido, Japan. 11. Molecular Function and Imaging Program, National Cardiac PET Centre, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, ON, Canada, K1Y 4W7. PNery@ottawaheart.ca. 12. Arrhythmia Service, Division of Cardiology, Department of Medicine, University of Ottawa Heart Institute, Ottawa, ON, Canada. PNery@ottawaheart.ca.
Abstract
PURPOSE: Cardiac sarcoidosis (CS) is a cause of conduction system disease (CSD). (18)F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population. METHODS: We recruited steroid-naive patients with newly diagnosed CSD due to CS. All CS patients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups: group A with chronic mild CSD (right bundle branch block and/or axis deviation), and group B with new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB). RESULTS: Thirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p = 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 - 34.3, vs. 72.0, IQR 25.0 - 79.5 days; p = 0.03). CONCLUSION: The number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS.
PURPOSE:Cardiac sarcoidosis (CS) is a cause of conduction system disease (CSD). (18)F-Fluorodeoxyglucose-positron emission tomography (FDG PET) and cardiac magnetic resonance (CMR) are used for detection of CS. The relative diagnostic value of these has not been well studied. The aim was to compare these imaging modalities in this population. METHODS: We recruited steroid-naive patients with newly diagnosed CSD due to CS. All CSpatients underwent both imaging studies within 12 weeks of each other. Patients were classified into two groups: group A with chronic mild CSD (right bundle branch block and/or axis deviation), and group B with new-onset atrioventricular block (AVB, Mobitz type II or third-degree AVB). RESULTS: Thirty patients were included. Positive findings on both imaging studies were seen in 72 % of patients (13/18) in group A and in 58 % of patients (7/12) in group B. The remainder (28 %) of the patients in group A were positive only on CMR. Of the patients in group B, 8 % were positive only on CMR and 33 % were positive only on FDG PET. Patients in group A were more likely to be positive only on CMR, and patients in group B were more likely to be positive only on FDG PET (p = 0.02). Patients in group B positive only on FDG PET underwent CMR earlier relative to their symptomatology than patients positive only on CMR (median 7.0, IQR 1.5 - 34.3, vs. 72.0, IQR 25.0 - 79.5 days; p = 0.03). CONCLUSION: The number of positive FDG PET and CMR studies was different in patients with CSD depending on their clinical presentation. This study demonstrated that CMR can adequately detect cardiac involvement associated with chronic mild CSD. In patients presenting with new-onset AVB and a negative CMR study, FDG PET may be useful for detecting cardiac involvement due to CS.
Entities:
Keywords:
18F-Fluorodeoxyglucose positron emission tomography; Atrioventricular block; Cardiac magnetic resonance; Cardiac sarcoidosis; Conduction system disease
Authors: Pablo B Nery; Rob S Beanlands; Girish M Nair; Martin Green; Jim Yang; Brian A McArdle; Darryl Davis; Hiroshi Ohira; Michael H Gollob; Eugene Leung; Jeff S Healey; David H Birnie Journal: J Cardiovasc Electrophysiol Date: 2014-05-02
Authors: T Shimada; K Shimada; T Sakane; K Ochiai; H Tsukihashi; M Fukui; S Inoue; H Katoh; Y Murakami; Y Ishibashi; R Maruyama Journal: Am J Med Date: 2001-05 Impact factor: 4.965
Authors: Ron Blankstein; Michael Osborne; Masanao Naya; Alfonso Waller; Chun K Kim; Venkatesh L Murthy; Pedram Kazemian; Raymond Y Kwong; Michifumi Tokuda; Hicham Skali; Robert Padera; Jon Hainer; William G Stevenson; Sharmila Dorbala; Marcelo F Di Carli Journal: J Am Coll Cardiol Date: 2013-10-16 Impact factor: 24.094
Authors: Patrick Krumm; Stefanie Mangold; Sergios Gatidis; Konstantin Nikolaou; Felix Nensa; Fabian Bamberg; Christian la Fougère Journal: Jpn J Radiol Date: 2018-03-10 Impact factor: 2.374
Authors: David R Okada; Paco E Bravo; Tomas Vita; Vikram Agarwal; Michael T Osborne; Viviany R Taqueti; Hicham Skali; Panithaya Chareonthaitawee; Sharmila Dorbala; Garrick Stewart; Marcelo Di Carli; Ron Blankstein Journal: J Nucl Cardiol Date: 2016-09-09 Impact factor: 5.952