Abstract 12962: Prognostic Value of Simultaneous Hybrid 18 F-fluorodeoxyglucose Positron Emission Tomography/magnetic Resonance Imaging in Cardiac Sarcoidosis

Abstract

Background: Cardiac magnetic resonance imaging with late gadolinium enhancement (LGE) and 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) are widely used modalities for the diagnosis of cardiac sarcoidosis. The aim of this study was to examine the prognostic value of simultaneous hybrid 18 F-FDG PET/MRI in cardiac sarcoidosis. Methods: Forty-three consecutive patients with suspected cardiac sarcoidosis underwent cardiac FDG PET/MRI. The patients were categorized based on the presence or absence of LGE and/or FDG uptake in the myocardium. The end points were defined as composite of all-cause death, sustained ventricular tachyarrhythmia, hospitalization due to decompensated heart failure and a decline of left ventricular ejection fraction more than 10%. Results: During the median follow-up of 3.7 ± 1.3 years, there were 16 (33%) adverse events. Accumulated event rate was higher in the LGE positive group than in the LGE negative group (log-rank, P < 0.001, Figure A) Additionally, the FDG positive group showed higher adverse event rate than the FDG negative group (P < 0.001, Figure B). Furthermore, adverse event rate was highest in the both PET- and LGE-positive group among 4 groups (P < 0.001, Figure C). In the Cox proportional hazard analysis adjusted for other potential confounding factors, the presence of LGE and the presence of FDG uptake were independent predictors of adverse events (LGE: HR 11.1, 95% CI 1.3-92.4, P = 0.013; FDG: HR 4.4, 95% CI 1.4-13.2, P = 0.007) in cardiac sarcoidosis. Conclusion: Simultaneous cardiac PET/MRI with FDG identifies patients at higher risk for adverse events in patients with cardiac sarcoidosis.