Saleh Jamal K, Barkmeier Daniel, Frey Kirk A, Davenport Matthew S
Department of Radiology, University of Michigan, 1500 E. Medical Center Dr, Ann Arbor, MI, 48109, USA.
Department of Diagnostic Imaging, The Hospital for Sick Children, 555 University Avenue, Toronto, ON, M5G 1H4, Canada.
J Nucl Cardiol. 2023 Oct;30(5):1773-1781. doi: 10.1007/s12350-023-03222-6. Epub 2023 Feb 24.
Whole-body F-18 FDG PET has been included in the 2014 Heart Rhythm Society guidelines for cardiac sarcoidosis evaluation to identify alternate sites of biopsy prior to endomyocardial biopsy. The purpose of this study was to evaluate the diagnostic yield of whole-body F-18 FDG PET/CT.
All adult patients with suspected cardiac sarcoidosis undergoing same-day cardiac F-18 FDG PET/CT and whole-body F-18 FDG PET/CT between 10/1/2016 and 6/14/2021 to assess potential biopsy sites were retrospectively identified. Clinical indications, findings, recommendations, and outcomes were assessed.
Eighty-eight patients were included. Extracardiac PET findings suggestive of sarcoidosis were present in 30 patients (34%), 27 of which had thoracic findings (90%). Sarcoidosis was diagnosed in 11% of patients. Only 1% (1/88) was diagnosed by extrathoracic biopsy of a whole-body PET finding. Incidental findings were common (31%), resulting in 11 additional tests or interventions. Recommendations from extrathoracic findings affected treatment in one case: a drainage catheter placement into an unsuspected pelvic abscess.
Addition of whole-body F-18 FDG PET/CT to cardiac F-18 FDG PET/CT for the identification of extrathoracic sites of biopsy in patients with suspected cardiac sarcoidosis has marginal diagnostic yield but commonly results in incidental findings that rarely affect patient outcome.
全身F-18 FDG PET已被纳入2014年心律协会关于心脏结节病评估的指南，用于在心肌内膜活检前确定其他活检部位。本研究的目的是评估全身F-18 FDG PET/CT的诊断效能。
回顾性纳入2016年10月1日至2021年6月14日期间所有因疑似心脏结节病而同日接受心脏F-18 FDG PET/CT和全身F-18 FDG PET/CT检查以评估潜在活检部位的成年患者。评估临床指征、检查结果、建议和结局。
共纳入88例患者。30例患者（34%）有提示结节病的心脏外PET检查结果，其中27例有胸部检查结果（90%）。11%的患者被诊断为结节病。仅1%（1/88）通过对全身PET检查发现进行胸外活检确诊。偶然发现很常见（31%），导致另外进行了11项检查或干预。胸外检查结果的建议在1例中影响了治疗：在一个未被怀疑的盆腔脓肿中放置引流导管。
对于疑似心脏结节病的患者，在心脏F-18 FDG PET/CT基础上加做全身F-18 FDG PET/CT以识别胸外活检部位，其诊断效能有限，但常导致偶然发现，很少影响患者结局。
