所属 医学部 医学科（東京女子医科大学病院） 職種 助教
|発表タイトル||The Incidence and Clinical Significance of 18F-fluorodeoxyglucose Re-uptake on Cardiac Positron Emission Tomography in Patient with Cardiac Sarcoidosis at Follow-up|
|発表者・共同発表者||◎芹澤直紀, 百瀬満, 福島賢慈, 野村新, 志賀剛, 萩原誠久|
|学会抄録||第81回日本循環器学会学術集会 プログラム集 174|
|概要||Background: 18F‒fluorodeoxyglucose positron emission tomography(FDG‒PET) is useful for diagnosis and monitoring of cardiac sarcoidosis(CS) because of high sensitivity. However, we sometimes experience cases that show the FDG‒PET re‒uptake without disease exacerbation at follow‒up.
Methods: Detecting FDG‒PET re‒uptake and CS recurrence, we performed serial FDG‒PET(after>24hrs with low carbohydrate diet and 18hrs fasting and heparin administration), MRI or TL SPECT for 43 patients receiving corticosteroid therapy. FDG‒PET re‒uptake was defined as an increase in SUVmax compared to the latest data, and CS recurrence, as having MRI/TL SPECT or clinical exacerbation associated with FDG‒PET re‒uptake, or progression of FDG‒PET re‒uptake without increasing corticosteroid.
Results: Of 43 patients and 129 sessions, FDG‒PET re‒uptake was found in 16 patients(37%) and 18 sessions(14%). Patients with re‒uptake were significantly lower baseline LVEF than those without(39 ± 5% vs. 46 ± 10%, p=0.018). Meanwhile, the incidence of recurrence was 9 patients(56%) of 16 re‒uptake patients. Recurrence patients had significantly higher SUVmax at follow‒up and tended to be higher TL defect score at diagnosis than those without recurrence(5.0 ± 0.4 vs. 3.3 ± 0.5, p=0.018, 19 ± 12 vs. 7 ± 6, p=0.069). Best cut‒off value for recurrence by ROC curve analysis was SUVmax>3.5(AUC0.875, sensitivity100%, specificity67%).
Conclusions: FDG‒PET re‒uptake was common in advanced CS at follow‒up. Higher FDG‒PET re‒uptake might suggest CS recurrence. Conversely, lower FDG‒PET re‒uptake might be clinical insignificance.