Article Figures & Data
Figures
- FIGURE 1.
(A) Spearman correlation coefficients for associations between tissue characterization parameters provided by PET (myocardial-to-blood SUVmax ratio and myocardial uptake volume) or MRI (T1, T2, and number of late gadolinium enhancement [LGE] LV segments) and all considered PET and MRI variables. (B) Relationship between LV ejection fraction and myocardial-to-blood SUVmax ratio. (C) Relationship between LV ejection fraction and myocardial uptake volume.
- FIGURE 2.
(A–C) Comparison of myocardial uptake in AM-PET and Onc-PET groups in terms of myocardial uptake volume (A), myocardial-to-blood SUVmax ratio (B), and myocardial uptake detection rate on each of 17 LV segments (C). Difference in uptake detection rates between AM-PET and Onc-PET groups is particularly marked (P < 0.001) in inferior and inferior-lateral segments (columns delimited with dashed red lines) and weaker (P = ∼0.05) in anterior and anterior-septal segments located in basal and median parts of LV (columns delimited with dashed blue lines).
- FIGURE 3.
Receiver operating characteristic curves optimized to differentiate AM-PET group from Onc-PET group on basis of myocardial-to-blood SUVmax ratio and myocardial uptake volume. According to closest-to-(0,1) corner approach, we selected thresholds of 2.2 for myocardial-to-blood SUVmax ratio and 18 cm3 for myocardial uptake volume (arrows).
- FIGURE 4.
Representative fused PET/CT slices, on 0-to-2.5 SUV scale, of 41-y-old man in AM-PET group (diffuse and intense LV uptake) and of 3 Onc-PET patients with myocardial uptake: 71-y-old man with history of inferior myocardial infarction (MI; arrows mark uptake on inferior and inferoseptal segments),76-y-old woman with history of percutaneous transluminal angioplasty (PTCA; arrows mark uptake on proximal parts of anterior and septal walls), and 81-y-old man with no cardiovascular (CV) history (diffuse LV uptake). Myocardial-to-blood SUVmax ratio was 4.0 in AM-PET patient and ranged from 2.13 to 2.18 in Onc-PET patients.
Tables
- TABLE 1.
Main Data Recorded at Time of PET/CT in Overall Onc-PET Group, Onc-PET Subgroup with Myocardial Uptake, and AM-PET Group
Characteristic Overall Onc-PET Onc-PET with myocardial uptake AM-PET P All patients (n) 508 137 31 Female patients (n) 246 (48.3) 64 (46.7) 1 (3.2) <0.0001 Age (y) 64.0 (54.8–72.0) 65.7 (55.0–73.4) 26.5 (21.9–33.8) <0.0001 Body mass index (kg/m2) 25.5 (22.5–29.1) 26.1 (23.1–29.5) 24.9 (23.2–27.7) 0.27 CV history and risk factors (n) CAD history 40 (7.9) 14 (10.2) 0 (0) 0.075 Myocardial infarction history 24 (4.7) 9 (6.6) 0 (0) 0.21 No. CV risk factors 1 (0–2) 1 (0–2) 0 (0–1) 0.005 Active smoking 7 (1.4) 2 (1.5) 7 (22.6) 0.0001 Obesity 102 (20.1) 29 (21.3) 5 (16.7) 0.80 Treated hypertension 207 (40.7) 58 (42.3) 1 (3.2) <0.0001 Treated dyslipidemia 78 (15.3) 20 (14.6) 1 (3.2) 0.13 Treated diabetes 102 (20.0) 26 (19.0) 0 (0) 0.005 Oncologic data (n) Diagnosed cancer 466 (91.5) 124 (90.5) Diagnosed NET 423 (83.1) 111 (81.0) ≥2 tumor grade 275 (54.3) 68 (49.6) External radiotherapy history 100 (19.6) 28 (20.4) Internal radiotherapy history 87 (17.1) 17 (12.4) Oncologic surgery history 266 (52.3) 62 (45.3) Current chemotherapy 61 (12.0) 26 (19.0) Current immunotherapy 67 (13.2) 14 (10.2) Somatostatin analog treatment* 193 (37.9) 25 (18.2) CV PET/CT data Presence of myocardial uptake (n) 137 (26.9) 137 (100) 31 (100) 1 Segments with myocardial uptake (n) 0.0 (0.0–3.0) 6.0 (3.0–9.0) 15.0 (10.0–17.0) <0.0001 Myocardial uptake volume (cm3) 0.0 (0.0–0.09) 2.2 (0.6–9.5) 47.3 (24.0–135.0) <0.0001 Myocardial-to-blood SUVmax ratio 1.44 (1.25–1.79) 2.00 (1.76–2.18) 2.80 (2.29–3.00) <0.0001 ↵* Somatostatin analogs were not administered in 4 wk preceding PET.
CV = cardiovascular; NET = neuroendocrine tumor.
P values relate to comparison between AM-PET group and Onc-PET group with myocardial uptake. Qualitative data are number and percentage; continuous data are median and range.
- TABLE 2.
Univariate and Multivariate Predictors of Myocardial Uptake and Log-Transformed Myocardial-to-Blood SUVmax Ratio in Onc-PET Group
Myocardial uptake Ln of SUVmax ratio Univariate Multivariate Univariate Multivariate Characteristic exp(β) P exp(β) P exp(β) P exp(β) P Women 1.070 (0.620–1.848) 0.81 0.973 (0.877–1.079) 0.60 Age (y) 1.018 (0.993–1.044) 0.16 1.005 (1.001–1.009) 0.012 1.003 (0.999–1.006) 0.16 Body mass index (kg/m2) 1.049 (0.995–1.106) 0.075 1.006 (0.996–1.015) 0.23 CV history and risk factors CAD history 1.646 (0.758–3.572) 0.21 1.184 (1.024–1.369) 0.023 1.177 (1.024–1.353) 0.022 Myocardial infarction history 1.887 (0.717–4.964) 0.20 1.214 (1.015–1.451) 0.034 ≥1 CV risk factor 0.970 (0.587–1.602) 0.91 1.015 (0.922–1.118) 0.76 Active smoking 0.962 (0.127–7.285) 0.97 1.007 (0.676–1.500) 0.97 Obesity 1.329 (0.723–2.442) 0.36 1.043 (0.944–1.152) 0.41 Treated hypertension 1.076 (0.619–1.871) 0.80 0.957 (0.862–1.063) 0.42 Treated dyslipidemia 1.045 (0.482–2.264) 0.91 1.064 (0.924–1.225) 0.39 Treated diabetes 0.872 (0.433–1.756) 0.70 1.036 (0.910–1.178) 0.59 Oncologic data Diagnosed cancer 0.829 (0.380–1.805) 0.64 0.881 (0.769–1.009) 0.069 Diagnosed NET 0.730 (0.383–1.391) 0.34 0.978 (0.870–1.099) 0.70 ≥2 tumor grade 0.839 (0.481–1.463) 0.54 0.869 (0.783–0.963) 0.008 External radiotherapy history 1.090 (0.500–2.378) 0.83 1.044 (0.911–1.195) 0.54 Internal radiotherapy history 0.532 (0.264–1.071) 0.078 0.950 (0.848–1.065) 0.38 Oncologic surgery history 0.771 (0.459–1.297) 0.33 0.900 (0.820–0.989) 0.028 Current chemotherapy 1.639 (0.712–3.772) 0.25 1.008 (0.888–1.145) 0.90 Current immunotherapy 0.820 (0.399–1.686) 0.59 1.053 (0.939–1.180) 0.38 Current somatostatin analog treatment* 0.325 (0.171–0.619) 0.0007 0.805 (0.728–0.890) <0.0001 0.759 (0.695–0.830) <0.0001 0.761 (0.698–0.831) <0.001 ↵* Somatostatin analogs were not administered in 4 wk preceding PET.
CV = cardiovascular; NET = neuroendocrine tumor.
P values relate to comparison between AM-PET group and Onc-PET group with myocardial uptake. Data in parentheses are 95% CI.
Supplemental Data
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