Marschner Constantin A, Aloufi Faisal, Aitken Matthew, Cheung Edward, Thavendiranathan Paaladinesh, Iwanochko Robert M, Balter Meyer, Moayedi Yasbanoo, Duero Posada Juan, Hanneman Kate
From the Department of Medical Imaging (C.A.M., F.A., M.A., E.C., P.T., K.H.) and Division of Cardiology (P.T., M.R.I., Y.M., J.D.P.), Peter Munk Cardiac Centre, Toronto General Hospital, University Health Network, University of Toronto, 585 University Ave, 1 PMB-298, Toronto, ON, Canada M5G 2N2; Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, Canada (P.T., K.H.); Division of Molecular Imaging, Toronto General Hospital, University Health Network, University of Toronto, Toronto, Canada (M.R.I.); and Division of Respiratory Medicine, Sinai Health System, University of Toronto, Toronto, Canada (M.B.).
Radiol Cardiothorac Imaging. 2023 Sep 28;5(5):e220292. doi: 10.1148/ryct.220292. eCollection 2023 Oct.
To compare combined cardiac fluorine 18 (F) fluorodeoxyglucose (FDG) PET/MRI with standard-of-care evaluation using cardiac MRI, F-FDG PET/CT, and SPECT perfusion imaging in suspected cardiac sarcoidosis (CS) with respect to radiation dose, imaging duration, and diagnostic test performance.
Consecutive patients with suspected CS undergoing clinical evaluation with cardiac F-FDG PET/CT and gated rest technetium 99m sestamibi SPECT perfusion imaging were prospectively recruited between November 2017 and May 2021 for parallel assessment with combined cardiac F-FDG PET/MRI on the same day (ClinicalTrials.gov identifier, NCT03356756). Total effective radiation dose and imaging duration were compared between approaches (combined cardiac PET/MRI vs separate cardiac MRI, PET/CT, and SPECT). MRI findings were initially interpreted without PET data, and then PET and late gadolinium enhancement images were fused and interpreted together. Final diagnosis of CS was established using Japanese Ministry of Health and Welfare guidelines.
Forty participants (mean age, 54 years ± 14 [SD]; 26 [65%] male participants) were included, 14 (35%) with a final diagnosis of CS. Compared with separate cardiac MRI, PET/CT, and SPECT perfusion imaging, combined cardiac PET/MRI had 52% lower total radiation dose (8.0 mSv ± 1.2 vs 16.8 mSv ± 1.6, < .001) and 43% lower total imaging duration (122 minutes ± 15 vs 214 minutes ± 26, < .001). Combined PET/MRI had the highest area under the curve for diagnosis of CS (0.84) with 96% specificity and 71% sensitivity for colocalized FDG uptake and late gadolinium enhancement in a pattern typical for CS.
In the evaluation of suspected CS, combined cardiac F-FDG PET/MRI had a lower radiation dose, shorter imaging duration, and higher diagnostic performance compared with standard-of-care imaging.Clinical trial registration no. NCT03356756 Cardiac Sarcoidosis, F-FDG PET/MRI, F-FDG PET/CT, SPECT Perfusion Imaging, Cardiac MRI, Standard-of-Care Imaging © RSNA, 2023.
比较联合心脏氟代脱氧葡萄糖（FDG）PET/MRI与使用心脏MRI、F-FDG PET/CT和单光子发射计算机断层扫描（SPECT）灌注成像的标准治疗评估方法，在疑似心脏结节病（CS）患者中的辐射剂量、成像时间和诊断测试性能。
2017年11月至2021年5月，前瞻性招募连续的疑似CS患者，这些患者接受了心脏F-FDG PET/CT和门控静息锝99m甲氧基异丁基异腈SPECT灌注成像的临床评估，以便在同一天使用联合心脏F-FDG PET/MRI进行平行评估（ClinicalTrials.gov标识符，NCT03356756）。比较两种方法（联合心脏PET/MRI与单独的心脏MRI、PET/CT和SPECT）之间的总有效辐射剂量和成像时间。MRI结果最初在不参考PET数据的情况下进行解读，然后将PET和延迟钆增强图像融合并一起解读。CS的最终诊断依据日本厚生省指南确定。
纳入40名参与者（平均年龄54岁±14[标准差]；26名[65%]男性参与者），其中14名（35%）最终诊断为CS。与单独的心脏MRI、PET/CT和SPECT灌注成像相比，联合心脏PET/MRI的总辐射剂量降低了52%（8.0 mSv±1.2对比16.8 mSv±1.6，P<.001），总成像时间缩短了43%（122分钟±15对比214分钟±26，P<.001）。联合PET/MRI在诊断CS方面的曲线下面积最高（0.84），对于符合CS典型模式的FDG摄取和延迟钆增强，其特异性为96%，敏感性为71%。
在疑似CS的评估中，与标准治疗成像相比，联合心脏F-FDG PET/MRI的辐射剂量更低、成像时间更短且诊断性能更高。临床试验注册号：NCT03356756 心脏结节病、F-FDG PET/MRI、F-FDG PET/CT、SPECT灌注成像、心脏MRI、标准治疗成像 © RSNA，2023
