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Identification of Cardiac Sarcoidosis with 13N-NH3/18F-FDG PET

Hiroyuki Yamagishi, MD, Naoya Shirai, MD, Masahiko Takagi, MD, Minoru Yoshiyama, MD, Kaname Akioka, MD, Kazuhide Takeuchi, MD and Junichi Yoshikawa, MD

Department of Internal Medicine and Cardiology, Osaka City University Graduate School of Medicine, Osaka City University, Osaka, Japan



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FIGURE 1. 13N-NH3 and 18F-FDG PET images before and after steroid therapy in patient 12. Cardiac 13N-NH3 PET revealed moderate defects in basal anteroseptal wall of LV, and 18F-FDG PET revealed increased 18F-FDG uptake in basal anteroseptal-lateral wall and midanteroseptal wall of LV and free wall of right ventricle. After 1 mo of steroid therapy (prednisolone, 30 mg/d), increased 18F-FDG uptake in basal anteroseptal-lateral wall and midanteroseptal wall of LV was markedly diminished both in size and in intensity and that in free wall of right ventricle disappeared completely, whereas 13N-NH3 defects exhibited no significant change. 18F-FDG uptake indices of midanterior wall before and after steroid therapy were 2.8 and 1.8, respectively. Base = basal level of LV; Mid = middle level of LV.

 


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FIGURE 2. 13N-NH3 and 18F-FDG PET images before and after steroid therapy in patient 15. Cardiac 13N-NH3 PET revealed moderate defects in basal ventricular septum, and 18F-FDG PET revealed increased 18F-FDG uptake in basal and midanteroseptal wall of LV and free wall of right ventricle. After 1 mo of steroid therapy (prednisolone, 30 mg/d), increased 18F-FDG uptake in basal and midanteroseptal wall of LV and free wall of right ventricle disappeared completely, whereas 13N-NH3 defects exhibited no significant change. 18F-FDG uptake indices of midseptum before and after steroid therapy were 3.0 and 1.2, respectively. Base = basal level of LV; Mid = middle level of LV.

 





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