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Published in: Journal of Nuclear Cardiology 3/2021

01-06-2021 | Sarcoidosis | ORIGINAL ARTICLE

Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET

Authors: Atsushi Yamamoto, MD, Michinobu Nagao, MD, Eri Watanabe, MD, Yasutaka Imamura, MD, Atsushi Suzuki, MD, Kenji Fukushima, MD, Kiyoe Ando, MD, Risako Nakao, MD, Akiko Sakai, MD, Mitsuru Momose, MD, Shuji Sakai, MD, Nobuhisa Hagiwara, MD

Published in: Journal of Nuclear Cardiology | Issue 3/2021

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Abstract

Background

We analyzed 18F-Fludeoxyglucose positron emission tomography (FDG-PET) and 123I-betamethyl-p-iodophenyl-pentadecanoic acid (BMIPP) single-photon emission computed tomography (SPECT) performed for cardiac sarcoidosis (CS) patients taking prednisolone, identified recurrence by FDG-PET, and investigated BMIPP as a recurrence and prognostic factor in CS.

Methods and Results

CS patients who underwent BMIPP and FDG-PET within 2 months were enrolled. The recurrence-free group included patients with standardized uptake value (SUVmax) < 4 in the myocardium consecutively for ≥ 2 years. The total BMIPP SPECT defect score (BDS) was used to estimate myocardial damage. The predictability of the initial BDS and SUVmax for major adverse cardiac events (MACE) was analyzed using Kaplan–Meier analysis. Overall, 73 patients and 250 BMIPP and FDG-PET sets were analyzed retrospectively (mean follow-up, 3.5 years). The BDS was significantly greater for the recurrence group (N = 21) vs recurrence-free group (20 ± 13 vs 14 ± 12, P = 0.041). Patients with BDS ≥16 had a significantly higher MACE rate than patients with BDS < 16 (log-rank test, P = 0.016). However, MACE occurrence was comparable between patients with SUVmax ≥ 4 and < 4.

Conclusions

BDS is a predictive marker of recurrence and MACE. SUV is not related to MACE. Recurrence, defined by prednisolone treatment-induced SUV variability, was observed in approximately 30% of CS patients.
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Metadata
Title
Prognosis and recurrence in cardiac sarcoidosis: Serial assessment of BMIPP SPECT and FDG-PET
Authors
Atsushi Yamamoto, MD
Michinobu Nagao, MD
Eri Watanabe, MD
Yasutaka Imamura, MD
Atsushi Suzuki, MD
Kenji Fukushima, MD
Kiyoe Ando, MD
Risako Nakao, MD
Akiko Sakai, MD
Mitsuru Momose, MD
Shuji Sakai, MD
Nobuhisa Hagiwara, MD
Publication date
01-06-2021
Publisher
Springer International Publishing
Published in
Journal of Nuclear Cardiology / Issue 3/2021
Print ISSN: 1071-3581
Electronic ISSN: 1532-6551
DOI
https://doi.org/10.1007/s12350-021-02567-0

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