Comparison of 68Ga-DOTANOC PET/CT with cardiac MRI in patients with clinical suspicion of cardiac sarcoidosis.

Abstract

BACKGROUND:

68Ga-DOTA-NaI-octreotide (DOTANOC) is a promising new alternative to 18F-fluorodeoxyglucose (FDG) for imaging inflammation in cardiac sarcoidosis. The aim of the study was to compare 68Ga-DOTANOC positron emission tomography/computed tomography (PET/CT) with cardiac magnetic resonance imaging (CMR) in patients with clinical suspicion of cardiac sarcoidosis.

METHODS AND RESULTS:

Patients with extracardiac sarcoidosis and clinical suspicion of cardiac involvement underwent 68Ga-DOTANOC cardiac PET/CT, myocardial perfusion single photon emission computed tomography (MPS) and CMR (T2-weighted and delayed gadolinium-enhanced T1-weighted images). The patients were screened using revised criteria of Japanese circulation society. Presence of perfusion defects on MPS, abnormal myocardial uptake on 68Ga-DOTANOC PET/CT and characteristic pattern of late gadolinium enhancement (LGE) with or without T2 hyperintensity on CMR was considered positive.

RESULTS:

Seventeen patients (13 male and 4 female) were included in the study. Out of the 17 patients, both CMR and PET were positive in 11 and both were negative in 2. In the remaining 4 patients, CMR was positive but PET was normal. Thus, PET and CMR were concordant in 13 (76.5%) patients and discordant in 4 (23.5%). Intermodality agreement was fair (Cohen's kappa = 0.39).

CONCLUSION:

LGE on CMR is superior to 68Ga-DOTANOC PET/CT for detecting cardiac involvement in sarcoidosis and there is fair concordance between the two. However, since LGE does not specifically differentiate between inflammation and fibrosis, 68Ga-DOTANOC PET/CT may be better than CMR in identifying patients with active inflammation, since it directly targets inflammatory cells and can have a complementary role to CMR.

• Authors: Prateek Kaushik, Chetan Patel, Gurpreet S Gulati, Sandeep Seth, Neeraj Parakh, Randeep Guleria, Rajeev Kumar, Priyanka Gupta, Chandrasekhar Bal
• Journal: Annals of nuclear medicine (Ann Nucl Med) Vol. 35 Issue 9 Pg. 1058-1065 (Sep 2021) ISSN: 1864-6433 [Electronic] Japan
• PMID: 34125376 (Publication Type: Journal Article)
• Copyright: © 2021. The Japanese Society of Nuclear Medicine.

Chemical References

• Fluorodeoxyglucose F18

Topics

• Adult
• Female
• Fluorodeoxyglucose F18
• Humans
• Magnetic Resonance Imaging
• Male
• Middle Aged
• Positron Emission Tomography Computed Tomography
• Sarcoidosis