Combined simultaneous FDG-PET/MRI with T1 and T2 mapping as an imaging biomarker for the diagnosis and prognosis of suspected cardiac sarcoidosis

Cheung, Edward; Ahmad, Sarah; Aitken, Matthew; Chan, Rosanna; Iwanochko, Robert M.; Balter, Meyer; Metser, Ur; Veit-Haibach, Patrick; Billia, Filio; Moayedi, Yasbanoo; Ross, Heather J.; Hanneman, Kate

doi:10.1186/s41824-021-00119-w

EJNMMI Reports

Table 2 Combined PET/MRI findings

From: Combined simultaneous FDG-PET/MRI with T1 and T2 mapping as an imaging biomarker for the diagnosis and prognosis of suspected cardiac sarcoidosis

	All patients (n = 42)	Cardiac sarcoidosis (n = 13)	Not cardiac sarcoidosis (n = 29)	P value
Cardiac MRI
Left ventricle
LVEDVi, ml/m²	89 ± 26	88 ± 18	90 ± 29	0.84
LVEF, %	52 ± 11	52 ± 12	52 ± 10	0.97
LVMi, g/m²	50 ± 12	50 ± 13	51 ± 14	0.86
Tissue characterization
LGE presence, n (%)	33 (79%)	13 (100%)	20 (69%)	0.038
LGE extent, number of segments	4.7 ± 4.8	4.2 ± 2.4	4.9 ± 5.6	0.49
Global native T1, ms	1263 ± 73	1274 ± 74	1257 ± 73	0.49
Regional native T1, ms	1344 ± 91	1377 ± 58	1328 ± 100	0.040
Elevated native T1, n (%)	30 (73%)	13 (100%)	17 (61%)	0.008
Global ECV, %	28 ± 6	28 ± 6	27 ± 6	0.73
Regional ECV, %	34 ± 8	38 ± 8	33 ± 8	0.044
Elevated ECV, n (%)	30 (73%)	13 (100%)	17 (61%)	0.008
Global native T2, ms	40 ± 3	41 ± 2	39 ± 3	0.09
Regional native T2, ms	45 ± 5	46 ± 5	44 ± 5	0.045
Elevated native T2, n (%)	12 (29%)	6 (46%)	6 (21%)	0.15
MRI positive, n (%)	33 (79%)	13 (100%)	20 (69%)	0.038
Extra-cardiac findings
Pulmonary opacities, n (%)	18 (43%)	10 (77%)	8 (28%)	0.006
Thoracic lymphadenopathy, n (%)	16 (38%)	9 (69%)	7 (24%)	0.014
FDG-PET
FDG-PET positive, n (%)	18 (43%)	9 (69%)	9 (31%)	0.041
Focal pattern of uptake, n (%)	17 (40%)	8 (61%)	9 (31%)	0.09
Focal on diffuse pattern of uptake, n (%)	1 (2%)	1 (7%)	0 (0%)	0.31
Diffuse FDG uptake, n (%)	1 (2%)	0 (0%)	1 (3%)	0.99
FDG-PET extent, number of segments	2.4 ± 4.2	3.7 ± 4.9	1.9 ± 4.2	0.035
CMV, cm³	23 ± 43	39 ± 43	15 ± 41	0.015
Extra-cardiac FDG uptake typical of sarcoidosis, n (%)	17 (40%)	8 (62%)	9 (31%)	0.09
Combined PET/MRI
PET+ and/or MRI+, n (%)	34 (81%)	13 (100%)	21 (72%)	0.043
PET−/MRI−, n (%)	8 (19%)	0 (0%)	8 (28%)	0.043
PET+/MRI−, n (%)	1 (2%)	0 (0%)	1 (3%)	0.99
PET−/MRI+, n (%)	16 (38%)	4 (31%)	12 (41%)	0.73
PET+/MRI+, n (%)	17 (40%)	9 (69%)	8 (27%)	0.017
Co-localized focal FDG uptake and LGE, n (%)	16 (38%)	9 (69%)	7 (24%)	0.014
Co-localized focal FDG uptake and high T1, n (%)	16 (38%)	9 (69%)	7 (24%)	0.014
Co-localized focal FDG uptake and high T2, n (%)	11 (26%)	6 (46%)	5 (17%)	0.07

Variables are presented as mean ± standard deviation or number with percentage in parentheses. P values are for the comparison between patients with cardiac sarcoidosis and those without
PET was considered positive (+) if the pattern of FDG uptake was focal or focal on diffuse. MRI was considered positive (+) if LGE was present or if native T1, T2 or ECV were elevated
LV Left ventricle, LVEDVi indexed left ventricular end-diastolic volume, LVESVi indexed left ventricular end-systolic volume, LVEF left ventricular ejection fraction, LVCO left ventricular cardiac output, LVMi indexed left ventricular mass, RV right ventricle, RVEDVi indexed right ventricular end-diastolic volume, RVESVi indexed right ventricular end-systolic volume, RVEF right ventricular ejection fraction, RVCO right ventricular cardiac output, LGE late gadolinium enhancement, ECV extracellular volume, MRI magnetic resonance imaging, FDG fluorodeoxyglucose, PET positron emission tomography

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