Abstract 15942: Low Agreement of 18F-Fluorodeoxyglucose-Positron Emission Tomography (FDG-PET) and Cardiac Magnetic Resonance (CMR) in Patients With Conduction Disease Due to Cardiac Sarcoidosis
Background: Cardiac sarcoidosis (CS) is considered to be one of the important causes of atrioventricular block (AVB) in young and middle aged adults. Thus, an accurate diagnosis of CS with AVB is important. 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET) and cardiac magnetic resonance (CMR) are the current modalities for detection of CS. However, the characteristics of these two imaging might be different. The aim of this study was to evaluate characteristics of these imaging modalities in this population.
METHODS: We included 33 patients from 2 centers presenting with conduction disease (CD) and subsequently diagnosed with CS based on the diagnostic criteria from the Japanese Ministry of Health and Welfare (2006). Patients underwent both FDG-PET and CMR within 12 weeks. The presence of focal FDG uptake on FDG-PET and late gadolinium enhancement (LGE) on CMR were defined as positive. Patients were classified into 2 groups: mild CD (right bundle branch block and/or axis deviation) and advanced AVB (second degree AVB type II or third degree AVB) (Table 1). We also included 15 patients with idiopathic advanced AVB as controls (FDG-PET: n = 8; FDG-PET&MRI: n = 7).
Results: FDG-PET and CMR showed fair agreement in patients with mild CD. (prevalence adjusted bias adjusted kappa <PABAK> =0.37). The sensitivity of FDG-PET was good (68%) while that of CMR was excellent (100%) in mild CD group. However, in patients with advanced AVB, the 2 modalities had less agreement (PABAK =0.14). In this group, the sensitivity of FDG-PET (93%) was high and that of CMR (64%) was lower. The specificity of CMR was 100% and that of FDG-PET was 87% (Table 1).
Conclusions: The agreement of FDG-PET and CMR is low in patients with CD. FDG-PET is sensitive in advanced AVB. MRI is sensitive in mild CD. Our results suggest that the detection of cardiac involvement may vary depending on the stage of the CD in patients with CS.
- © 2013 by American Heart Association, Inc.