Molecular imaging of metastatic atrial angiosarcoma with positron emission tomography (PET) tracer 3'-deoxy-3'[(18)F]-fluorothymidine, [(18)F]-FLT imaging and early response evaluation.

Primary cardiac angiosarcoma, the most common primary cardiac sarcoma has an incidence ranging from 0.001% to 0.028% in autopsy reports with around 200 cases reported in literature. Since a diagnosis of cardiac angiosarcoma portends a poor prognosis, it is vital to ascertain the precise extent of the lesions for follow-up. Imaging with positron emission tomography (PET) tracer 2-deoxy-2-[18F]-fluoro-D-glucose in cardiac angiosarcoma is challenging as myocardium takes up glucose and delineation of tumour becomes difficult. Cell proliferation rate in normal cardiac muscular tissue is low whereas cardiac tumours display a higher proliferation rate. This aspect could be exploited by use of 3'-deoxy-3'[(18)F]-fluorothymidine positron emission tomography (18F-FLT PET/CT] in cardiac tumours where the cell proliferation could be measured. Herein, we imaged an index case of cardiac angiosarcoma using 18F-FLT PET/CT and report the findings. © BMJ Publishing Group Limited 2019. No commercial re-use. See rights and permissions. Published by BMJ.