Nuclear Medicine Service, Department of Radiology, New Jersey Medical School, Rutgers University, H-141, 150 Bergen Street, Newark, NJ, 07103, USA.
J Nucl Cardiol. 2019 Aug;26(4):1205-1211. doi: 10.1007/s12350-018-01524-8. Epub 2018 Nov 15.
Cardiac uptake on oncologic FDG PET/CT can be unpredictable. Focal or mass-like cardiac uptake not confined to normal pattern is a real challenge for interpretation due to great variability in physiologic uptake and rarity of either primary or metastatic cardiac neoplasms.
Eight patients with suspicious mass-like cardiac uptake on oncologic FDG PET/CT were retrospectively analyzed with correlation to cardiac workups including contrast CT, echocardiography, and repeat PET/CT. Four patients had real cardiac lesions or metastases. Focal uptake was benign and might represent papillary muscle in the other four. SUV ratio between the cardiac focus and surrounding background cardiac uptake was statistically higher in the true-positive group than that in the false-positive group. In addition, the patients with true-positive cardiac uptake had more diffuse distant metastases compared to those with false-positive cardiac uptake.
Focal suspicious cardiac uptake on oncology FDG PET/CT warranted further evaluation. SUV ratio between the cardiac focus and surrounding background cardiac uptake and status of distant metastases might help to differentiate malignant from benign nature of the focal cardiac uptake on FDG PET/CT. Focal uptake of the right ventricle on oncologic FDG PET/CT is more likely suggestive of a neoplasm.
肿瘤 FDG PET/CT 的心脏摄取可能是不可预测的。由于生理摄取的变异性很大，原发性或转移性心脏肿瘤的罕见性，因此对于局限于正常模式的局灶性或块状心脏摄取，其解释具有真正的挑战性。
回顾性分析了 8 例肿瘤 FDG PET/CT 上可疑块状心脏摄取的患者，其与包括对比 CT、超声心动图和重复 PET/CT 的心脏检查结果相关。4 例患者存在真正的心脏病变或转移。4 例局灶性摄取为良性，可能代表心肌中的乳头肌。真阳性组的心脏病灶与周围背景摄取的 SUV 比值明显高于假阳性组。此外，与假阳性心脏摄取的患者相比，真阳性心脏摄取的患者具有更广泛的远处转移。
肿瘤 FDG PET/CT 上局灶性可疑心脏摄取需要进一步评估。心脏病灶与周围背景摄取的 SUV 比值以及远处转移的状态可能有助于区分 FDG PET/CT 上局灶性心脏摄取的恶性和良性性质。肿瘤 FDG PET/CT 上右心室的局灶性摄取更可能提示为肿瘤。
