Quantitative assessment of cardiac hypermetabolism from Flourodeoxy glucose (FDG) positron emission tomography (PET) may improve diagnosis of cardiac sarcoidosis (CS). We assessed different approaches for quantification of cardiac hypermetabolism and perfusion in patients with suspected CS. Consecutive patients undergoing FDG PET assessment for possible CS between January 2014 and March 2019 were included. Cardiac hypermetabolism was quantified using maximal standardized uptake value (SUV), cardiometabolic activity (CMA) and volume of inflammation, using relative thresholds (1.3× and 1.5× left ventricular blood pool [LVBP] activity), and absolute thresholds (SUV > 2.7 and 4.1). Diagnosis of CS was established using the Japanese Ministry of Health and Wellness criteria. In total, 69 patients were studied, with definite or possible CS in 29(42.0%) patients. CMA above 1.5× LVBP SUV had the highest area under the receiver operating characteristic curve (AUC 0.92). Quantitative parameters using relative thresholds had higher AUC compared to absolute thresholds ( < 0.01). Interobserver variability was low for CMA, with excellent agreement regarding absence of activity (Kappa 0.970). Quantitation with scan-specific thresholds has superior diagnostic accuracy compared to absolute thresholds. Based on the potential clinical benefit, programs should consider quantification of cardiac hypermetabolism when interpreting F-FDG PET studies for CS.

中文翻译：

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心脏代谢亢进和灌注的定量评估用于诊断心脏结节病


通过氟脱氧葡萄糖 (FDG) 正电子发射断层扫描 (PET) 对心脏代谢亢进进行定量评估可以改善心脏结节病 (CS) 的诊断。我们评估了疑似 CS 患者心脏代谢亢进和灌注的不同量化方法。纳入了 2014 年 1 月至 2019 年 3 月期间连续接受 FDG PET 评估可能发生 CS 的患者。使用最大标准化摄取值（SUV）、心脏代谢活动（CMA）和炎症体积，使用相对阈值（1.3×和1.5×左心室血池[LVBP]活动）和绝对阈值（SUV > 2.7和4.1）。 CS 的诊断是根据日本卫生保健部的标准制定的。总共有 69 名患者接受了研究，其中 29 名（42.0%）患者明确或可能患有 CS。高于 1.5× LVBP SUV 的 CMA 具有最高的受试者工作特征曲线下面积 (AUC 0.92)。与绝对阈值相比，使用相对阈值的定量参数具有更高的 AUC (< 0.01)。 CMA 的观察者间变异性较低，在缺乏活动方面具有极好的一致性（Kappa 0.970）。与绝对阈值相比，使用特定扫描阈值进行定量具有更高的诊断准确性。基于潜在的临床益处，在解释 CS 的 F-FDG PET 研究时，计划应考虑对心脏代谢亢进进行量化。