Physiological myocardial ۱۸F-FDG uptake pattern in oncologic PET/CT: comparison with findings in cardiac sarcoidosis

Objective(s): Physiological myocardial ۱۸F-fluorodeoxyglucose (۱۸F-FDG) uptake in oncologic positron emission tomography (PET)/computed tomography (CT) is commonly observed with multiple variations under clinical fasting conditions. The purpose of the present study was to evaluate physiological myocardial ۱۸F-FDG uptake pattern by comparing with the results in cardiac sarcoidosis.Methods: A total of ۱۷۴ examinations in ۱۷۴ patients without cardiac disease and ۲۷ examinations in ۱۷ patients with cardiac sarcoidosis were performed. The polar map images generated from ۱۸F-FDG PET/CT data were visually assessed as “basal-ring,” “focal,” and “focal on diffuse” patterns. Semi-quantitative analysis was also performed using the regional relative ۱۸F-FDG uptake (% uptake).Results: On visual analysis, the “focal on diffuse” pattern was the most common in both examinations (۴۳% and ۵۹%, respectively). The physiological % uptake in the lateral and basal septal walls tended to be higher. Subgroup analysis showed significantly higher uptake in the mid-wall and left circumflex territory. In cardiac sarcoidosis patients, there was a significant difference only between segments ۲ and ۱۵ (p=۰.۰۴). No significant differences were observed between the base-mid-apical territory and coronary artery branch territory.Conclusion: High ۱۸F-FDG uptake in the basal septal walls is likely to be observed as both physiological uptake in patients without cardiac disease and pathological uptake in patients with cardiac sarcoidosis.

Keywords:

۱۸F-FDG , PET , physiological uptake