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Updated: Apr 30, 2026
High-Resolution Cardiac Positron Emission Tomography/Computed Tomography for Small Animals
Published on: December 16, 2022
Positron emission tomography-computed tomography for imaging of inflammatory cardiovascular diseases
Masao Miyagawa1, Rami Yokoyama, Yoshiko Nishiyama
1Department of Radiology, Ehime University Graduate School of Medicine.
Insights
Positron emission tomography (PET) with (18)F-fluorodeoxyglucose (FDG) is a rapidly evolving imaging technique for cardiovascular inflammation. It aids in early diagnosis and risk stratification of inflammatory heart conditions like cardiac sarcoidosis.
Area of Science:
- Cardiovascular Imaging
- Nuclear Medicine
- Inflammatory Diseases
Background:
- Inflammation drives atherosclerotic plaque rupture, leading to myocardial infarction and stroke.
- Inflammatory cardiomyopathy can stem from myocarditis, eosinophilic disease, and sarcoidosis.
- Conventional imaging lacks insight into inflammatory status, unlike advanced PET/CT.
Purpose of the Study:
- To review the clinical utility of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for inflammatory cardiovascular diseases.
- To highlight advances and future applications of FDG-PET in cardiovascular imaging.
- To assess the value of FDG-PET following its Japanese health insurance approval for cardiac sarcoidosis.
Main Methods:
- Review of current literature on FDG-PET for inflammatory cardiovascular diseases.
- Discussion of integrated PET/computed tomography (CT) for arterial inflammation quantification.
- Emphasis on standardized protocols for suppressing physiological uptake and enhancing lesion detection.
Main Results:
- Integrated PET/CT quantifies arterial inflammation and assesses inflammatory cell activation.
- FDG-PET enables early diagnosis and risk stratification in patients with inflammatory cardiovascular conditions.
- Japanese approval for FDG-PET in cardiac sarcoidosis necessitates further clinical value assessment.
Conclusions:
- FDG-PET is a valuable tool for imaging inflammatory cardiovascular diseases, including atherosclerosis, large-vessel arteritis, and cardiac sarcoidosis.
- Standardized protocols are crucial for optimizing FDG-PET specificity and sensitivity.
- Continued research and development promise expanded applications for FDG-PET in cardiovascular medicine.
Abstract:
Inflammation is a determinant of atherosclerotic plaque rupture, the event usually responsible for myocardial infarction and stroke. Possible causes of inflammatory cardiomyopathy include myocarditis, eosinophilic disease, and sarcoidosis. Although conventional imaging techniques can identify the site and severity of luminal stenosis, they do not provide information regarding inflammatory status. (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) for imaging of inflammatory cardiovascular diseases has been rapidly evolving. Integrated PET/computed tomography (CT) is becoming the method of choice for quantification of arterial inflammation across multiple vessels. Moreover, PET/CT provides information about the activation status of inflammatory cells in the vessel wall, thus allowing early diagnosis and risk stratification of patients. The Japanese health insurance system approved reimbursement for FDG-PET use to detect inflammation sites in cardiac sarcoidosis as of April 2012. This approval has necessitated a more detailed assessment of the clinical value of FDG-PET. Standardized preparation, imaging, and image interpretation protocols should be established to sufficiently suppress physiological FDG uptake in the normal myocardium, and thereby facilitate detection of early-stage cardiac inflammatory lesions with more favorable specificity. This review summarizes the background, clinical utility, state-of-the-art advances, and potential future applications of FDG-PET for imaging inflammatory cardiovascular diseases including cardiac sarcoidosis, large-vessel arteritis, and atherosclerosis.
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