Semi-quantitative metabolic values on FDG PET/CT including extracardiac sites of disease as a predictor of treatment course in patients with cardiac sarcoidosis.
Semi-quantitative metabolic values on FDG PET/CT including extracardiac sites of disease as a predictor of treatment course in patients with cardiac sarcoidosis.
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DOI：
10.1186/s13550-017-0315-y
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发表时间：
2017-08-18
期刊：
影响因子：
3.2
通讯作者：
Vesselle HJ
中科院分区：
文献类型：
--
作者：
Ishiyama M;Soine LA;Vesselle HJ
心脏结节病与主要不良心脏事件相关，包括心脏骤停，需要抗炎治疗。口服皮质类固醇是主要的治疗选择；然而，副作用是长期使用的一个主要问题。尽管仍然具有挑战性，但预测结节病的治疗反应和预后以制定正确的结节病管理策略对于医疗服务提供者来说将是有益的。氟（F）-18氟脱氧葡萄糖（FDG）-正电子发射断层扫描（PET）/计算机断层扫描（CT）在提供半定量功能参数（例如标准摄取值（SUV）、代谢量和总病灶糖酵解（TLG））方面比解剖成像具有优势，这些参数是肿瘤学中成熟的生物标志物。然而，这些参数与心脏结节病治疗反应之间的关系尚未得到充分研究。此外，FDG-PET/CT 记录的心外活动性炎症对于心脏结节病的预后价值尚不清楚。本回顾性研究的目的是探讨 FDG-PET/CT 得出的心脏和心外疾病部位的半定量值在预测心脏结节病治疗过程中的预后价值。纳入了 16 名连续疑似心脏结节病患者，这些患者在覆盖整个胸部/上腹部的心脏炎症 FDG-PET/CT 上显示心肌活动异常，随后接受皮质类固醇治疗以诊断为活动性心脏结节病。代谢亢进病变的半定量值来自所有可视化器官系统，并与 6 个月时每日皮质类固醇剂量进行比较。 16例患者中，81.3%（13/16）的患者出现心外受累。 SUV 最大的病变位于 11 名患者 (68.7%) 的心脏、1 名患者 (6.3%) 的肝脏和 4 名患者 (25%) 的淋巴结。包括心脏在内的所有可视化器官系统的最大SUV对于皮质类固醇剂量≤ 10mg的患者为8.8±3.1，对于> 10mg的患者为12.5±3.3（P=0.04）。所有可视化器官系统的代谢量和 TLG 或仅心脏的任何值显示两组之间没有显着的统计差异。胸部和上腹部所有相关器官系统（而不仅仅是心脏）的最大 SUV 可能是活动性心脏结节病患者 6 个月时类固醇治疗疗程的预测因子。
Cardiac sarcoidosis is associated with major adverse cardiac events including cardiac arrest, for which anti-inflammatory treatment is indicated. Oral corticosteroid is the mainstay among treatment options; however, adverse effects are a major concern with long-term use. It would be beneficial for providers to predict treatment response and prognosis for proper management strategy of sarcoidosis, though it remains challenging. Fluorine (F)-18 fluorodeoxyglucose (FDG)-positron emission tomography(PET)/computed tomography(CT) has an advantage over anatomical imaging in providing semi-quantitative functional parameters such as standard uptake value (SUV), metabolic volume, and total lesion glycolysis (TLG), which are well-established biomarkers in oncology. However, the relationship between these parameters and treatment response has not been fully investigated in cardiac sarcoidosis. Also, the prognostic value of extracardiac active inflammation noted on FDG-PET/CT in the setting of cardiac sarcoidosis is unclear. The aim of this retrospective study was to investigate the prognostic value of semi-quantitative values of both cardiac and extracardiac disease sites derived from FDG-PET/CT in predicting treatment course in cardiac sarcoidosis. Sixteen consecutive patients with suspected cardiac sarcoidosis, who demonstrated abnormal myocardial activity on cardiac-inflammation FDG-PET/CT encompassing the entire chest/upper abdomen and subsequently underwent corticosteroid therapy for diagnosis of active cardiac sarcoidosis, were included. Semi-quantitative values of hypermetabolic lesions were derived from all visualized organ system and were compared to daily corticosteroid dose at 6 months. Of the 16 patients, 81.3% (13/16) of the patients showed extracardiac involvement. 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 lymph nodes in 4 patients (25%). The maximum SUV across all visualized organ systems including the heart were 8.8 ± 3.1 for the patients with corticosteroid dose ≤ 10 mg and 12.5 ± 3.3 for those with > 10 mg (P = 0.04). Metabolic volume and TLG across all visualized organ systems or any values in the heart alone showed no significant statistical difference between the two groups. Maximum SUV across all involved organ-systems of the chest and upper abdomen, not that of the heart alone, could be a predictor of treatment course of steroid therapy at 6 months in patients with active cardiac sarcoidosis.
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影响因子：
4.3
作者：
Mostard, Remy L. M.;Verschakelen, Johny A.;Drent, Marjolein
通讯作者：
Drent, Marjolein
影响因子：
4.3
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影响因子：
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影响因子：
9.3
作者：
Sobic-Saranovic, Dragana;Grozdic, Isidora;Obradovic, Vladimir
通讯作者：
Obradovic, Vladimir
影响因子：
3.1
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Mostard RL;Van Kuijk SM;Verschakelen JA;van Kroonenburgh MJ;Nelemans PJ;Wijnen PA;Drent M
通讯作者：
Drent M