Immunology, University Hospitals of Strasbourg, Strasbourg, France.
Mallinckrodt Institute of Radiology, Division of Nuclear Medicine, Washington University, St Louis, MO.
Clin Nucl Med. 2020 Sep;45(9):e416-e418. doi: 10.1097/RLU.0000000000003185.
Cardiac sarcoidosis (CS) has a poor prognosis related to life-threating arrhythmias and heart failure. Treatment includes anti-inflammatory therapies and implantable pacemaker and/or cardioverter defibrillator. The presence of cardiac devices and physiologic myocardial glucose uptake are major limitations of both cardiac magnetic resonance and F-FDG PET/CT, reducing their diagnostic value. Somatostatin-based PET/CT has been proposed to detect active CS. Contrarily to F-FDG uptake, which reflects nonspecific leukocyte infiltration, Ga-DOTATOC may identify active granulomatosis. Herein, we underline the specificity of Ga-DOTATOC PET in challeging clinical situations including refractory CS, and chronic CS in patients with cardiac device, or false-positive F-FDG PET/CT results.
心脏结节病(CS)预后不良,与危及生命的心律失常和心力衰竭有关。治疗包括抗炎治疗以及植入式起搏器和/或除颤器。心脏设备的存在和心肌葡萄糖摄取的生理性是心脏磁共振和 F-FDG PET/CT 的主要限制,降低了它们的诊断价值。基于生长抑素的 PET/CT 已被提议用于检测活动性 CS。与反映非特异性白细胞浸润的 F-FDG 摄取相反,Ga-DOTATOC 可识别活动性肉芽肿病。在此,我们强调了 Ga-DOTATOC PET 在包括难治性 CS 和心脏设备患者的慢性 CS 以及假阳性 F-FDG PET/CT 结果等具有挑战性的临床情况下的特异性。