Trivieri, Maria Giovanna and Robson, Philip M. and Vergani, Vittoria and LaRocca, Gina and Romero-Daza, Angelica M. and Abgral, Ronan and Devesa, Ana and Azoulay, Levi-Dan and Karakatsanis, Nicolas A. and Parikh, Aditya and Panagiota, Christia and Palmisano, Anna and DePalo, Louis and Chang, Helena L. and Rothstein, Joseph H. and Fayad, Rima A. and Miller, Marc A. and Fuster, Valentin and Narula, Jagat and Dweck, Marc R. and Morgenthau, Adam and Jacobi, Adam and Padilla, Maria and Kovacic, Jason C. and Fayad, Zahi A. (2024) Hybrid Magnetic Resonance Positron Emission Tomography Is Associated With Cardiac-Related Outcomes in Cardiac Sarcoidosis. JACC: Cardiovascular Imaging, 17 (4). pp.411-424. ISSN 1936878X
Full text not available from this repository.Abstract
BACKGROUND: Imaging with late gadolinium enhancement (LGE) magnetic resonance (MR) and (18)F-fluorodeoxyglucose ((18)F-FDG) PET allows complementary assessment of myocardial injury and disease activity and has shown promise for improved characterization of active cardiac sarcoidosis (CS) based on the combined positive imaging outcome, MR(+)PET(+). OBJECTIVES: This study aims to evaluate qualitative and quantitative assessments of hybrid MR/PET imaging in CS and to evaluate its association with cardiac-related outcomes. METHODS: A total of 148 patients with suspected CS underwent hybrid MR/PET imaging. Patients were classified based on the presence/absence of LGE (MR+/MR-), presence/absence of (18)F-FDG (PET+/PET-), and pattern of (18)F-FDG uptake (focal/diffuse) into the following categories: MR(+)PET(+)(FOCAL), MR(+)PET(+)(DIFFUSE), MR(+)PET(-), MR(-)PET(+)(FOCAL), MR(-)PET(+)(DIFFUSE), MR(-)PET(-). Further analysis classified MR positivity based on %LGE exceeding 5.7% as MR(+/-)(5.7%). Quantitative values of standard uptake value, target-to-background ratio, target-to-normal-myocardium ratio (TNMRmax), and T2 were measured. The primary clinical endpoint was met by the occurrence of cardiac arrest, ventricular tachycardia, or secondary prevention implantable cardioverter-defibrillator (ICD) before the end of the study. The secondary endpoint was met by any of the primary endpoint criteria plus heart failure or heart block. MR/PET imaging results were compared between those meeting or not meeting the clinical endpoints. RESULTS: Patients designated MR(+)(5.7%)PET(+)(FOCAL) had increased odds of meeting the primary clinical endpoint compared to those with all other imaging classifications (unadjusted OR: 9.2 [95% CI: 3.0-28.7]; P = 0.0001), which was higher than the odds based on MR or PET alone. TNMRmax achieved an area under the receiver-operating characteristic curve of 0.90 for separating MR(+)PET(+)(FOCAL) from non-MR(+)PET(+)(FOCAL), and 0.77 for separating those reaching the clinical endpoint from those not reaching the clinical endpoint. CONCLUSIONS: Hybrid MR/PET image-based classification of CS was statistically associated with clinical outcomes in CS. TNMRmax had modest sensitivity and specificity for quantifying the imaging-based classification MR(+)PET(+)(FOCAL) and was associated with outcomes. Use of combined MR and PET image-based classification may have use in prognostication and treatment management in CS.
| Item Type: | Article |
|---|---|
| Subjects: | R Medicine > R Medicine (General) |
| Depositing User: | Repository Administrator |
| Date Deposited: | 16 Dec 2024 04:21 |
| Last Modified: | 16 Dec 2024 04:21 |
| URI: | https://eprints.victorchang.edu.au/id/eprint/1538 |
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