PET Myocardial Sarcoidosis: The Anti-Viability Study

2706 Objectives A review of our experiences with implementing PET imaging for detection, treatment and monitoring of Myocardial Sarcoidosis. Introduction of this procedure as an aid to physicians managing a difficult and potentially life threatening disease, while expanding the type of clinical exams which can be offered as a clinical PET service. The more PET expands from a one clinical exam to a true multi exam modality the less vulnerable we will be to market forces. Methods Cardiac sarcoidosis is a rare disease in which clusters of white blood cells form in the tissue of the heart, and sometimes throughout the body. Myocardial Sarcoidosis is seen in PET by increasing glucose metabolism in the heart, due to the sarcoidosis not the heart being in a state of glucose metabolism. Unlike imaging PET Myocardial Viability, where the objective is to have the heart in glucose metabolism, for this study we want the heart in a state of fatty acid metabolism so any cardiac uptake you see is caused by the sarcoidosis, not normal heart tissue. To accomplish this, patient preparation includes prolonged fasting (12 hours), dietary restrictions and a pre-FDG injection heparin load. PET evaluation is accomplished by injecting FDG and allowing 90 minutes of uptake. The scan ensues with a 30 minute acquisition centered on the chest, and other parts of the body as necessary. Results Since we have started offering this study, our volume has increased modestly. We are following patients during treatment. With practice, our patient prep is now producing high quality, reproducible images, which are important for treatment monitoring in this patient population. Referring physicians have expressed appreciation for a new way to evaluate and track their patients. Conclusions Introducing new clinical services that utilize readily available FDG and provide our referring physicians with answers that are otherwise hard to obtain is a win/win scenario for all involved. Implementing this cardiac sarcoidosis imaging can lead to increases in patient volume, while offering referring physicians a new diagnostic tool for patients with a difficult disease to manage clinically. Patients, are able to be diagnosed sooner with better treatment monitoring then is currently available.