Yi Jeong-Eun, Yoon Hyuk Jin, O Joo Hyun, Youn Ho-Joong
Division of Cardiology, Department of Internal Medicine, Ewha Womans University Mokdong Hospital, Ewha Womans University School of Medicine, Seoul, Korea.
Division of Cardiology, Department of Internal Medicine, Seoul, St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
J Cardiovasc Imaging. 2018 Jun;26(2):93-102. doi: 10.4250/jcvi.2018.26.e10. Epub 2018 Jun 25.
Interpretation of cardiac uptake on 18-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is often confounded by intense physiological FDG uptake and numerous benign conditions. The aim of the study was to describe the echocardiographic features in concordance with cardiac and pericardial F-FDG uptake on whole-body oncology PET/CT.
We enrolled 43 consecutive patients (34 solid tumors, 8 lymphomas and 1 leukemia) who were newly diagnosed with non-cardiac malignancy showing incidental cardiac or pericardial F-FDG uptake on PET/CT and underwent transthoracic Doppler echocardiography (TTE) within 1 month of PET/CT. The maximum standardized uptake (SUV) of all lesions was measured.
Fifty-six F-FDG uptake lesions (32 pericardium, 7 myocardium, 9 cardiac chambers and 8 great vessels) were found, and pericardial effusion was the most common echocardiographic finding (22/43, 51.2%) among study population. Pericardial FDG uptake was shown as pericardial effusion (68.8%), intrapericardial echogenic materials (31.3%), pericardial thickening (28.1%), hyperechogenicity of myopericardium (18.8%), and restricted sliding movement or constrictive pericarditis (15.6%) on TTE. Lesions with regional wall motion abnormality ( = 0.004) or constrictive pericarditis ( = 0.021) had significantly higher mean SUV than those without. Myocardial FDG uptake demonstrated pericardial effusion (57.1%), regional wall motion abnormality (57.1%), and increased myocardial wall thickness (42.9%). All cardiac chamber FDG uptakes showed intracardiac mass on TTE.
Cardiac or pericardial F-FDG uptake on oncology PET/CT shows characteristic echocardiographic features according to which heart sites are involved.
18-氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）上心脏摄取的解读常常因强烈的生理性FDG摄取和众多良性情况而混淆。本研究的目的是描述与全身肿瘤PET/CT上心脏和心包F-FDG摄取相一致的超声心动图特征。
我们纳入了43例连续患者（34例实体瘤、8例淋巴瘤和1例白血病），这些患者新诊断为非心脏恶性肿瘤，在PET/CT上显示有偶然的心脏或心包F-FDG摄取，并在PET/CT后1个月内接受了经胸多普勒超声心动图（TTE）检查。测量了所有病变的最大标准化摄取值（SUV）。
发现56个F-FDG摄取病变（32个心包、7个心肌、9个心腔和8个大血管），心包积液是研究人群中最常见的超声心动图表现（22/43，51.2%）。心包FDG摄取在TTE上表现为心包积液（68.8%）、心包内回声物质（31.3%）、心包增厚（28.1%）、心肌心包高回声（18.8%）以及受限的滑动运动或缩窄性心包炎（15.6%）。有节段性室壁运动异常（ = 0.004）或缩窄性心包炎（ = 0.021）的病变平均SUV显著高于无此表现的病变。心肌FDG摄取表现为心包积液（57.1%）、节段性室壁运动异常（57.1%）和心肌壁厚度增加（42.9%）。所有心腔FDG摄取在TTE上均显示心内肿块。
肿瘤PET/CT上心脏或心包F-FDG摄取根据受累心脏部位显示出特征性的超声心动图特征。
