Department of Nuclear Medicine, Sant'Orsola-Malpighi University Hospital, Bologna, Italy.
Clin Nucl Med. 2013 Apr;38(4):e171-7. doi: 10.1097/RLU.0b013e31827a27df.
This study aimed to prospectively investigate F-FDG PET/CT role for the assessment of sarcoidosis activity and extension in comparison with thoracic high-resolution CT (HRCT) and to evaluate the potential clinical impact of PET/CT findings. Secondary aim was to investigate the changes in cardiac FDG uptake related to the specific preparation before PET/CT.
We prospectively enrolled biopsy proven sarcoidosis patients consecutively referred for F-FDG PET/CT since January 2010. PET/CT was performed after a fat meal followed by 12-hour fasting and compared with thoracic HRCT results obtained in supine position and clinical follow-up. The impact on the clinical management was recorded.Patterns of cardiac FDG uptake of the study group were compared with a historical population in which PET/CT was performed following standard preparation.
A total of 28 patients were enrolled, and 35 PET/CT scans were reviewed. On a scan basis, PET/CT was concordant with HRCT in 16 (45.7%), detecting active disease in 10/16 and no signs of activity in 4/16. PET/CT data had a direct impact on management in 4/16.In 19 (54.3%) discordant scans, PET/CT finding was positive in 14 and negative in 5. PET/CT findings influenced the clinical management in 18/19 cases.Considering all scans, PET/CT information influenced the clinical management of 22 (63%) of 35.Our data suggest that cardiac FDG uptake may vary regardless of the preparation before PET/CT.
F-FDG PET/CT was useful to assess sarcoidosis activity and extension and provided valuable information for the clinical management in a single-step examination. Additional data are needed to better ascertain the optimal patient preparation before image acquisition to improve sensitivity of heart lesions.
本研究旨在前瞻性评估 F-FDG PET/CT 在评估结节病活性和范围方面的作用，与胸部高分辨率 CT（HRCT）进行比较，并评估 PET/CT 结果的潜在临床影响。次要目的是研究与 PET/CT 前特定准备相关的心脏 FDG 摄取变化。
我们前瞻性纳入了 2010 年 1 月以来因 F-FDG PET/CT 连续就诊的活检证实的结节病患者。PET/CT 在进餐后进行，然后禁食 12 小时，并与仰卧位获得的胸部 HRCT 结果和临床随访进行比较。记录对临床管理的影响。研究组的心脏 FDG 摄取模式与进行标准准备的历史人群进行了比较。
共纳入 28 例患者，共进行了 35 次 PET/CT 扫描。基于扫描结果，PET/CT 与 HRCT 一致 16 次（45.7%），在 16 次中检测到活动性疾病 10 次，无活动性疾病 4 次。4 次扫描的 PET/CT 数据对管理有直接影响。在 19 次（54.3%）不一致的扫描中，14 次扫描 PET/CT 结果阳性，5 次阴性。18/19 次扫描的 PET/CT 结果影响了临床管理。考虑到所有扫描，35 次扫描中有 22 次（63%）的 PET/CT 信息影响了临床管理。我们的数据表明，无论 PET/CT 前的准备如何，心脏 FDG 摄取可能会发生变化。
F-FDG PET/CT 可用于评估结节病的活性和范围，并在单次检查中为临床管理提供有价值的信息。需要进一步的数据来更好地确定图像采集前的最佳患者准备，以提高心脏病变的敏感性。
