Impact of respiratory gating and ECG gating on 18F-FDG PET/CT for cardiac sarcoidosis

• Published in: Journal of Nuclear Cardiology Vol. 30; no. 5; pp. 1879 - 1885
• Main Authors: Hanaoka, Kohei, Watanabe, Shota, Morimoto-Ishikawa, Daisuke, Kaida, Hayato, Yamada, Takahiro, Yasuda, Masakazu, Iwanaga, Yoshitaka, Nakazawa, Gaku, Ishii, Kazunari
• Format: Journal Article
• Language: English
• Published: Cham Elsevier Inc 01.10.2023; Elsevier BV; Springer International Publishing; Springer Nature B.V
• Subjects: Brief Report; cardiac sarcoidosis; Cardiology; ECG-gated PET; Electrocardiography; FDG; Imaging; Medicine; Medicine & Public Health; Nuclear Medicine; Radiology; respiratory-gated PET; Sarcoidosis; Tomography; CS; cardiac sarcoidosis; FDG; SUVmax; ECG-gated PET; CMV; respiratory-gated PET; PET
• ISSN: 1071-3581; 1532-6551; 1532-6551
• DOI: 10.1007/s12350-023-03236-0

The aim of this study was to estimate the impact of respiratory and electrocardiogram (ECG)-gated FDG positron emission tomography (PET)/computed tomography (CT) on the diagnosis of cardiac sarcoidosis (CS). Imaging from thirty-one patients was acquired on a PET/CT scanner equipped with a respiratory- and ECG-gating system. Non-gated PET images and three kinds of gated PET/CT images were created from identical list-mode clinical PET data: respiratory-gated PET during expiration (EX), ECG-gated PET at end diastole (ED), and ECG-gated PET at end systole (ES). The maximum standardized uptake value (SUVmax) and cardiac metabolic volume (CMV) were measured, and the locations of FDG accumulation were analyzed using a polar map. The mean SUVmax of the subjects was significantly higher after application of either respiratory-gated or ECG-gated reconstruction. Conversely, the mean CMV was significantly lower following the application of respiratory-gated or ECG-gated reconstruction. The segment showing maximum accumulation was shifted to the adjacent segment in 25.8%, 38.7%, and 41.9% of cases in EX, ED, and ES images, respectively. In FDG PET/CT scanning for the diagnosis of CS, gated scanning is likely to increase quantitative accuracy, but the effect depends on the location and synchronization method.