Performance of cardiac PET/CT with and without phase analysis for detection of scar in cardiac sarcoidosis: Comparison to cardiac magnetic resonance imaging
Performance of cardiac PET/CT with and without phase analysis for detection of scar in cardiac sarcoidosis: Comparison to cardiac magnetic resonance imaging
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DOI：
10.1007/s12350-020-02473-x
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发表时间：
2021-01-20
影响因子：
2.4
通讯作者：
Bois, John P.
中科院分区：
文献类型：
--
作者：
Elwazir, Mohamed Y.;Bird, Jared G.;Bois, John P.
背景冠状动脉综合征患者心肌瘢痕的存在导致预后不良和预后恶化。F-18-氟脱氧葡萄糖（F-18-FDG）PET/CT在可视化炎症方面表现出色，但在检测瘢痕方面表现不佳。我们评估了PET/CT检测疤痕的灵敏度，并研究了自动PET衍生数据的增量诊断价值。方法收集176例在3个月内接受心脏磁共振（CMR）和N-13氨/F-18-FDG心脏PET/CT检查的疑似CS患者。瘢痕定义为CMR上的晚期钆增强（LGE），F-18-FDG PET/CT上无一致的F-18-FDG摄取。在添加自动PET衍生数据之前和之后，评估心脏PET/CT检测瘢痕（无一致F-18-FDG摄取的灌注缺损）的准确性。结果PET/CT诊断瘢痕的敏感性为45.3%（特异性88.9%）。在逻辑回归模型中添加PET衍生的LV体积和功能将灵敏度提高至57.0%（特异性：80.0%，AUC 0.72）。增加相位分析最大节段性心肌收缩起始> 61改善AUC至0.75，正确地将16.3%的患者重新标记为瘢痕（净重新分类指数8.2%）。结论门控PET MPI单独用于CS瘢痕检测的灵敏度不理想。添加PET衍生的体积/功能和相位分析数据导致改善的疤痕检测和表征。
Background The presence of myocardial scar in CS patients results in poor prognosis and worse outcomes. F-18-fluorodeoxyglucose (F-18-FDG) PET/CT excels at visualizing inflammation but is suboptimal at detecting scar. We evaluated PET/CT sensitivity to detect scar and investigated the incremental diagnostic value of automated PET-derived data. Methods 176 patients who underwent cardiac magnetic resonance (CMR) and N-13 ammonia/F-18-FDG cardiac PET/CT for suspected CS within 3 months were enrolled. Scar was defined as late gadolinium enhancement (LGE) on CMR without concordant F-18-FDG uptake on F-18-FDG PET/CT. Accuracy of cardiac PET/CT at detecting scar (perfusion defect without concordant F-18-FDG uptake) was assessed before and after addition of automated PET-derived data. Results Sensitivity of PET/CT for scar detection was 45.3% (specificity 88.9%). Addition of PET-derived LV volumes and function in a logistic regression model improved sensitivity to 57.0% (specificity: 80.0%, AUC 0.72). Addition of phase analysis maximum segmental onset of myocardial contraction > 61 improved AUC to 0.75, correctly relabeling 16.3% of patients as scar (net reclassification index 8.2%). Conclusion Sensitivity of gated PET MPI alone for scar detection in CS is suboptimal. Adding PET-derived volumes/function and phase analysis data results in improved detection and characterization of scar.