Combined cardiac 18F-FDG PET/MRI yielded a 52% lower total radiation dose (8.0 vs 16.8 mSv; P<.001) and 43% shorter imaging duration than standard-of-care imaging for suspected cardiac sarcoidosis.
Observational (n=40)
Does combined cardiac 18F-FDG PET/MRI reduce radiation dose and imaging duration and improve diagnostic performance compared to standard-of-care imaging in patients with suspected cardiac sarcoidosis?
Combined cardiac 18F-FDG PET/MRI offers a more efficient, lower-radiation alternative to standard-of-care multimodality imaging for diagnosing cardiac sarcoidosis, with high diagnostic accuracy.
Absolute Event Rate: 8% vs 16.8%
p-value: p=<.001
Purpose To compare combined cardiac fluorine 18 (18F) fluorodeoxyglucose (FDG) PET/MRI with standard-of-care evaluation using cardiac MRI, 18F-FDG PET/CT, and SPECT perfusion imaging in suspected cardiac sarcoidosis (CS) with respect to radiation dose, imaging duration, and diagnostic test performance. Materials and Methods Consecutive patients with suspected CS undergoing clinical evaluation with cardiac 18F-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 18F-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. Results 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, P < .001) and 43% lower total imaging duration (122 minutes ± 15 vs 214 minutes ± 26, P < .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. Conclusion In the evaluation of suspected CS, combined cardiac 18F-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 Keywords: Cardiac Sarcoidosis, 18F-FDG PET/MRI, 18F-FDG PET/CT, SPECT Perfusion Imaging, Cardiac MRI, Standard-of-Care Imaging Supplemental material is available for this article. © RSNA, 2023
Marschner et al. (Thu,) conducted a observational in Suspected cardiac sarcoidosis (n=40). Combined cardiac 18F-FDG PET/MRI vs. Standard-of-care imaging (separate cardiac MRI, 18F-FDG PET/CT, and SPECT perfusion imaging) was evaluated on Total effective radiation dose (p=<.001). Combined cardiac 18F-FDG PET/MRI yielded a 52% lower total radiation dose (8.0 vs 16.8 mSv; P<.001) and 43% shorter imaging duration than standard-of-care imaging for suspected cardiac sarcoidosis.