The physiological uptake pattern of &lt;SUP&gt;18&lt;/SUP&gt;F-FDG in the left ventricular myocardium of patients without heart disease

Nose, Hayato; Otsuka, Hideki; Otomi, Yoichi; Terazawa, Kaori; Sugiyama, Takao; Iwamoto, Seiji; Igarashi, Takashi; Yamada, Hirotsugu; Sata, Masataka; Harada, Masafumi

doi:10.2152/jmi.61.53

Cited by 21 publications

(12 citation statements)

References 16 publications

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“…The current definitions inevitably decreased the sensitivity, but rendered an improved specificity. Recent studies have demonstrated that most individuals without heart disease showed a ‘none’ or ‘diffuse’ pattern, ‘focal’ or ‘focal on diffuse’ uptake was mostly observed in unstable angina [11, 16]. These findings suggested that the pattern, rather than the extent, of 18 F-FDG uptake, is an indicator of myocardial involvement under fasting conditions.…”

Section: Discussionmentioning

confidence: 99%

“…Thereafter, the myocardial 18 F-FDG uptake of left ventricle as a whole was classified into four patterns, based on the results of semi-quantitative analysis as well as visual observation [11, 16, 17]: the ‘none’ pattern, indicated the SUV myo in all segments was below or equal to the SUV blood ; the ‘diffuse’ pattern, indicated the SUV myo in all segments was higher than the SUV blood , nonetheless no significant difference existed among them (i.e., homogenous uptake); the ‘focal’ pattern, indicated that at least one segment had a SUV myo higher than the SUV blood and the SUV myo in other segments was below or equal to the SUV blood ; and the ‘focal on diffuse’ pattern, indicated the SUV myo in all segments was higher than the SUV blood , and even higher uptake was identified in one or more segments. Finally, focal uptake in the ‘focal’ or ‘focal on diffuse’ pattern was defined as abnormal, except those on the basal segments and papillary muscle, which were considered normal [18].…”

Section: Methodsmentioning

confidence: 99%

“…Several studies have investigated the distribution pattern of 18 F-FDG in patients without heart disease [11, 16, 17]. These studies found that most individuals had no obvious 18 F-FDG uptake, or had diffuse but homogenous uptake.…”

Section: Introductionmentioning

confidence: 99%

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Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease

Dou¹,

Gao²,

Xie³

et al. 2017

BMC Cardiovasc Disord

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BackgroundMyocardial 18F-deoxyglucose (18F-FDG) uptake has been observed to be enhanced in patients with coronary artery disease (CAD) under fasting conditions. However, whether the increased 18F-FDG is induced by myocardial ischemia and how to discriminate ischemic from physiological 18F-FDG uptake have rarely been investigated.MethodsUnder fasting conditions, 18F-FDG PET imaging was performed in 52 patients with suspected CAD. Two 18F-FDG imaging sessions were conducted within two hours after a single administration of 18F-FDG (dual-time-point imaging), and with an intervention of an exercise test after the first imaging. Abnormal 18F-FDG uptake was determined by the classification of the 18F-FDG distribution pattern, and the changes of the 18F-FDG distribution between the two PET imaging sessions were analyzed. 99mTc-sestamibi was injected at peak exercise and myocardial perfusion imaging (MPI) was conducted after 18F-FDG imaging. Coronary angiography was considered the reference for diagnosing CAD.ResultsOverall, 54.8% (17/31) of CAD patients and 36.2% (21/58) of stenotic coronaries showed exercise-induced abnormal uptake of 18F-FDG. Based on the classification of the 18F-FDG distribution pattern, the sensitivity and specificity of exercise 18F-FDG imaging to diagnose CAD was 80.6% and 95.2% by patient analysis, 56.9% and 98.0% by vascular analysis, respectively. Compared with MPI, 18F-FDG imaging had a tendency to have higher sensitivity (80.6% vs 64.5%, P = 0.06) on the patient level.ConclusionMyocardial ischemia can induce 18F-FDG uptake. With the classification of the 18F-FDG distribution pattern, dual-time-point 18F-FDG imaging under fasting conditions is efficient in diagnosing CAD.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

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Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease

Dou¹,

Gao²,

Xie³

et al. 2017

BMC Cardiovasc Disord

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“…As described by Nose et al [29], myocardial 18 F-FDG uptake pattern can be classified as follows: (1) None (no myocardial 18 F-FDG uptake), (2) diffuse (diffuse and homogeneous 18 F-FDG uptake in the left ventricle), (3) focal myocardial 18 F-FDG uptake, and (4) focal on diffuse (focal 18 F-FDG uptake overlying the diffuse pattern) ( Figure 1A-D). The 18 F-FDG uptake pattern (3) focal and (4) focal on diffuse were further subdivided according to additional characteristics such as ring pattern (diffuse accumulation of 18 F-FDG in the basal left ventricular wall), over half pattern (more than 50% accumulation), and spotted pattern (less than 50% accumulation of 18 F-FDG) ( Figure 1E-I).…”

Section: Whole-body 18 F-fdg Pet/ct and Assessment Of Myocardial 18 Fmentioning

confidence: 99%

Myocardial 18F-FDG Uptake Pattern for Cardiovascular Risk Stratification in Patients Undergoing Oncologic PET/CT

Haider

Bengs

Schade

et al. 2020

JCM

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Objective: Positron emission tomography/computed tomography with 18F-fluorodeoxy-glucose (18F-FDG-PET/CT) has become the standard staging modality in various tumor entities. Cancer patients frequently receive cardio-toxic therapies. However, routine cardiovascular assessment in oncologic patients is not performed in current clinical practice. Accordingly, this study sought to assess whether myocardial 18F-FDG uptake patterns of patients undergoing oncologic PET/CT can be used for cardiovascular risk stratification. Methods: Myocardial 18F-FDG uptake pattern was assessed in 302 patients undergoing both oncologic whole-body 18F-FDG-PET/CT and myocardial perfusion imaging by single-photon emission computed tomography (SPECT-MPI) within a six-month period. Primary outcomes were myocardial 18F-FDG uptake pattern, impaired myocardial perfusion, ongoing ischemia, myocardial scar, and left ventricular ejection fraction. Results: Among all patients, 109 (36.1%) displayed no myocardial 18F-FDG uptake, 77 (25.5%) showed diffuse myocardial 18F-FDG uptake, 24 (7.9%) showed focal 18F-FDG uptake, and 92 (30.5%) had a focal on diffuse myocardial 18F-FDG uptake pattern. In contrast to the other uptake patterns, focal myocardial 18F-FDG uptake was predominantly observed in patients with myocardial abnormalities (i.e., abnormal perfusion, impaired LVEF, myocardial ischemia, or scar). Accordingly, a multivariate logistic regression identified focal myocardial 18F-FDG uptake as a strong predictor of abnormal myocardial function/perfusion (odds ratio (OR) 5.32, 95% confidence interval (CI) 1.73–16.34, p = 0.003). Similarly, focal myocardial 18F-FDG uptake was an independent predictor of ongoing ischemia and myocardial scar (OR 4.17, 95% CI 1.53–11.4, p = 0.005 and OR 3.78, 95% CI 1.47–9.69, p = 0.006, respectively). Conclusions: Focal myocardial 18F-FDG uptake seen on oncologic PET/CT indicates a significantly increased risk for multiple myocardial abnormalities. Obtaining and taking this information into account will help to stratify patients according to risk and will reduce unnecessary cardiovascular complications in cancer patients.

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“…High physiological uptake of FDG typically occurs in the brain, lymphoid tissue, liver, spleen, kidneys, and urinary tract (11) . In the thorax, normal metabolic activity can be seen in the myocardium (12) , great vessels, esophagus, thymus, breast (especially of lactating females), bone marrow, muscles, and brown fat (Figure 1) (13) .…”

Section: Physiological Fdg Uptakementioning

confidence: 99%

Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest

2017

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PET/CT is widely used for the evaluation of patients with thoracic malignancies. Although the levels of 18F-fluorodeoxyglucose (FDG) uptake are usually high in neoplastic diseases, they can also be physiological, due to artifacts. In addition, FDG uptake can occur in benign conditions such as infectious, inflammatory, and iatrogenic lesions. Furthermore, some malignant tumors, such as adenocarcinoma in situ (formerly known as bronchoalveolar carcinoma) and carcinoid tumors, may not show FDG uptake. Here, we illustrate the main pitfalls and artifacts in the interpretation of the results of oncologic PET/CT of the chest, outlining strategies for avoiding misinterpretation.

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The physiological uptake pattern of <SUP>18</SUP>F-FDG in the left ventricular myocardium of patients without heart disease

Abstract: The physiological myocardial uptake showed several patterns. Focal uptake was often seen in patients with cardiac disease, but it did not always indicate an abnormal finding when the accumulation was only on the basal wall.

Cited by 21 publications

References 16 publications

Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease

Dual-time-point myocardial 18F-FDG imaging in the detection of coronary artery disease

Myocardial 18F-FDG Uptake Pattern for Cardiovascular Risk Stratification in Patients Undergoing Oncologic PET/CT

Pitfalls and artifacts in the interpretation of oncologic PET/CT of the chest

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