TY - JOUR T1 - Prognostic value of FDG uptake on pretreatmen PET/CT in patients with cardiac sarcoidosis JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 1665 LP - 1665 VL - 57 IS - supplement 2 AU - Mitsutomi Ishiyama AU - Hubert Vesselle Y1 - 2016/05/01 UR - http://jnm.snmjournals.org/content/57/supplement_2/1665.abstract N2 - 1665Objectives The aim of this study is to investigate the prognostic significance of the semi-quantitative values derived from F-18 FDG PET/CT such as the maximum SUV (Standard Uptake Value), TLG (Total Lesion Glycolysis), and metabolic volume in predicting treatment response in patients with cardiac sarcoidosis. Methods This retrospective study included 16 patients with suspected cardiac sarcoidosis who demonstrated abnormal myocardial FDG uptake on dedicated cardiac-inflammation FDG PET/CT encompassing the entire chest and upper abdomen, and subsequently underwent corticosteroid therapy for a diagnosis of active cardiac sarcoidosis. Semi-quantitative values (maximum SUV, TLG, and metabolic volume) were derived from the lesions with abnormal FDG uptake in each visualized organ system using a maximum SUV threshold of 2.5 and visual assessment. These values were compared to the daily dose of prednisone at 6 months, dichotomized as either equal or less than 10mg or greater than 10mg, on which the patient was successfully maintained for the following 3 months without any clinical progression. Evidence of disease progression or lack of it was established by review of all subsequent clinical records. Mann-Whitney U test was used for statistical analysis. Results Out of 16 patients, 81.3% (13/16) of the patients showed extracardiac involvement in lymph nodes, 37.5% (6/16) in the lung parenchyma, 18.8% (3/16) in the liver, 25% (4/16) in the spleen, and 18.8% (3/16) in the bone. The lesion with the greatest SUV was identified in the heart in 11 patients (68.7%), in the liver in 1 patient (6.3%), and in either mediastinal or upper abdominal lymph node in 4 patients (25%). The maximum SUV, TLG, and metabolic volume of the total disease in all of the visualized organ systems were 8.8 +/- 3.1, 1340+/- 1849g, and 343 +/- 501mlfor the patients with prednisone therapy of equal or less than 10mg and 12.5 +/- 3.3, 1986 +/- 1054g, 449 +/- 215mlfor the patients with prednisone therapy of greater than 10mg (P= 0.04, 0.17, 0.13, respectively), with statistically significant difference in the maxmum SUV between two groups. None of the uptake metrices in the heart showed any significant statistical difference between the two groups. Conclusions The maximum SUV across all the involved organs of the chest and upper abdomen, not in the heart only, could be a predictor of treatment response to steroid therapy in patients with active cardiac sarcoidosis. This underscores the importance of imaging all sites of potential involvement when evaluating patients with suspected sarcoidosis and not limiting the scan to the cardiac region. ER -