Recommendations for 18 F-fluorodeoxyglucose positron emission tomography imaging for diagnosis of cardiac sarcoidosis —2018 update: Japanese Society of Nuclear Cardiology recommendations
AbstractSarcoidosis is a rare systemic disease characterized by growth and organization of inflammatory cells in a granuloma. Granulomas can localize in any parts of the human body. The main localization is represented by lungs, lymph nodes, eyes and skin. Any organ, however, can be affected. Central nervous system (CNS) represents a rare localization of sarcoidosis, in fact, only 1% of patient with sarcoidosis present brain and/or spinal cord localization of the granulomas associated with this disease. This condition takes the name of Neurosarcoidosis. Its diagnosis and management pose a significant challenge, as its clin...
We report the case of a 62-year-old woman with previous history of stage III Hodgkin lymphoma. Routine follow-up CT scan revealed 2 years after end of treatment the appearance of mediastinal nodes, suspected of lymphoma recurrence. An 18F-FDG PET/CT was performed showing hypermetabolic mediastinal lymph nodes with diffuse symmetric osteomedullar hypermetabolism of pelvis and scapulae. In the hypothesis of either recurrence or multisystemic inflammatory disorder, bone marrow and lymph node biopsies were performed, revealing the presence of noncaseating epithelioid cell granulomas, leading to the diagnosis of multisystemic s...
AbstractCardiac sarcoidosis (CS) causes lethal arrhythmia and heart failure and has a poor prognosis; therefore, early detection and early stage treatment are important. However, diagnosis of isolated CS may be difficult in some cases owing to the low sensitivity of myocardial biopsy. Herein, we describe the case of a patient with isolated CS, showing change from negative to positive fluorine ‐18 fluorodeoxyglucose (18F ‐FDG) positron emission tomography (PET) uptake results within 9 months. The patient showed rapid reduction in left ventricular systolic function with sustained ventricular tachycardia. The diagnos...
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Background: Current diagnostic criteria for cardiac sarcoidosis (CS) require histological confirmation from either cardiac or extracardiac specimens. Cardiac magnetic resonance imaging (CMR) and F18-fluorodeoxyglucose positron emission tomography (FDG-PET) are increasingly used to facilitate a non-invasive diagnosis of CS. We sought to compare CMR and cardiac PET findings in patients with suspected CS.
Background: Cardiac Magnetic Resonance (CMR) and Positron Emission Tomography (PET) are employed to diagnose Cardiac Sarcoidosis (CS). However, their role in prognosis and guiding treatment is not well established.
ConclusionsAccording to our results in a clinical setting of recurrent or residual lymphoma, FLT is not significantly superior to FDG and it is unlikely that it will be employed independently. FLT may be restricted to a few specific cases, as complementary to standard FDG imaging, to confirm a diagnosis or to define a better target to biopsy. However, due to FLT suboptimal performance, many findings would remain inconclusive, requiring further diagnostic procedures and reducing the effectiveness of performing an additional FLT scan.
ConclusionOur preliminary data suggest that, compared to FDG imaging, somatostatin receptor-targeted imaging may be less sensitive for the detection of myocardial inflammation, but comparable for detecting extra-cardiac inflammation.
ConclusionSUVmax and TLuG are equal in determining the response to infliximab in pulmonary sarcoidosis patients. Furthermore, SUVmax and TLuG at initiation of infliximab can predict change in lung function after treatment. Since TLuG is a more time-consuming tool, we recommend to use SUVmax of the lung parenchyma for response monitoring in pulmonary sarcoidosis.