Review of the first 5 years of dedicated FDG PET/CT for Cardiac Inflammation

Abstract

Aims
This study aimed to evaluate the effectiveness of cardiac 2-deoxy-(F) fluoro-D-glucose (FDG) PET/CT (F18 FDG PET/CT) in assessing cardiac inflammation, particularly in suspected cardiac sarcoidosis by analyzing patient compliance with dietary instruction and the effect this had on study accuracy.

Methods
A single centre audit was conducted on all cardiac F18 FDG PET/CTs from 2018 to 2023 inclusive. Data collected included patient demographics, referral sources, scan indications and myocardial suppression levels.

Results
Between November 2018 and December 2023, 73 F18 FDG PET/CT scans were performed on 53 patients, mostly male (41, 77%), with a mean age of 57 years. Internal referrals accounted for 29 cases (55%), while 24 (45%) originated from external hospitals. The primary indication was suspected cardiac sarcoidosis, with 30 patients also showing suspicion of extra-thoracic disease. One case involved suspected prosthetic valve infection. Adequate myocardial FDG suppression was achieved in 64 scans (87.7%), with 4 (5.4%) showing suboptimal suppression and 5 (6.8%) being non-diagnostic. In total, 68 scans (93.2%) yielded sufficient myocardial suppression to support a definitive radiological interpretation.

Discussion
This audit highlights the robust diagnostic performance of our FDG-PET/CT program in the evaluation of cardiac sarcoidosis and related conditions. Further investment in scanning capacity and protocol optimization, alongside ongoing technological and evidentiary advances, will enhance its integration into personalized cardiac care.