TY - JOUR T1 - <strong>Prognostic Role of Serial Quantitative Evaluation of <sup>18</sup>Fluorodeoxyglucose Uptake by PET/CT in Patients with Cardiac Sarcoidosis Presenting with Ventricular Tachycardia</strong> JF - Journal of Nuclear Medicine JO - J Nucl Med SP - 516 LP - 516 VL - 58 IS - supplement 1 AU - Simon Castro AU - Daniele Muser AU - Pasquale Santangeli AU - Silvia Magnani AU - Thomas Werner AU - Fermin Garcia AU - Benoit Desjardins AU - Francis Marchlinski AU - Abass Alavi Y1 - 2017/05/01 UR - http://jnm.snmjournals.org/content/58/supplement_1/516.abstract N2 - 516Background: Cardiac positron emission tomography (PET) with 18F-fluorodeoxyglucose (FDG) has shown to be useful in diagnosis, staging and monitor of patients with cardiac sarcoidosis (CS) but its interpretation is not standardized. Objectives: We sought to investigate the clinical impact of serial quantitative FDG-uptake analysis in patients with CS presenting with ventricular tachycardia (VT) treated by catheter ablation (CA).Methods: We followed 20 patients (51±9 years, 70% males) with CS and VT who underwent CA, with a total of 92 serial FDG-PET scans (range 3 to 10). Myocardial FDG-avid lesions were quantified using 3 parameters: maximum standardized uptake value (SUVmax), partial-volume corrected mean standardized uptake value (SUVmean) and partial-volume corrected volume-intensity product (lesion metabolic activity -LMA). Moreover, the global volume-intensity product of the entire heart (global cardiac metabolic activity – gCMA) and the basal cardiac metabolic activity (bCMA: difference between gCMA and LMA), were calculated per each PET scan. The primary end-point was a combined endpoint of major cardiac events (MCE), defined as death or heart transplant, hospitalization for heart failure and ICD appropriate interventions. Evolution of echocardiographic parameters over follow-up was also assessed.Results: During a median follow-up of 35 (20-66) months, 18 MCE (1 death, 2 heart transplants, 12 ICD appropriate interventions, 3 hospitalizations) occurred in 12 (60%) patients. At univariable analysis, lack of PET improvement (defined by decrease in LMA of at least 25%) was the only variable associated with cardiac events during follow-up. In particular, non-responders had a 20-fold higher risk of MCE at follow-up (HR 18.96, 95%CI 2.26-159.27; p=0.007). Moreover, a significant linear inverse relationship was observed between changes in LMA and changes in left ventricular ejection fraction over follow-up (β= -20.11; p=0.003).Conclusion: In patients with CS and VT, temporal reduction of FDG uptake evaluated by a quantitative approach is strongly associated with improvement in systolic function, better arrhythmia free survival, less mortality and less hospitalizations for heart failure ER -