心臓サルコイドーシスに対する F FDG PET検査の手引き …

1 PET . 18F FDG PET . Recommendation for 18F FDG PET imaging for cardiac sarcoidosis FDG PET .. 1 . 1992 #1 2006. 2 . #2 .. sampling error .. 67Ga .. 18F fluorodeoxyglucose FDG positron emission tomography PET . FDG .. FDG . GLUT1 GLUT3 .. glucose fatty acid cycle . GLUT4 GLUT4 . GLUT1/GLUT3 .. FDG PET 67Ga . 35. 35 1:07:40 PM.. 2012 4 . FDG PET .. FDG PET #2 .. FDG PET .. FDG PET .. #1 1992 . 1 . 1 .. 2 . a b e .. a Lown2. Q ST T . b . c 201Tl 67Ga 99mTc pyrophosphate PYP .. d .. e .. 1 Lown2 . b e . 2 . 3 . #2 2006 2 . 1 .. 2 . 36. 36 1:07:40 PM.. 6 2 . 1 4 2 . 2 4 1 2 . 1 . a . b . c 67Ga . d 50% . 2 . a . Q . b . c 201Tl, 99m Tc MIBI 99mTc TF.

2 D Gadolinium MRI . e .. ACE . 67Ga CD4/CD8 .. 1 . 2 .. 3 18F FDG PET . 4 . 5 ST . 6 . FDG PET . 1 :FDG . 90 10 3 4 . FDG . FDG PET . FDG 3 .. FDG . FDG 5 . 37. 37 1:07:40 PM.. FDG 6 6 . FDG PET/CT 4 6 7 FDG. PET/CT viability 6. 12 8 6 . 6 . 5 9 2004 . 1 . 12 5 . FDG PET . 91% 5 Youssef 89% 78% . 10 2 12 .. 12 .. Langah 18 11 85% 90% . 18 / .. <Recommendation>. FDG PET/CT . 12 .. FDG PET/CT . 150 200 mg/dL . 5 . FDG PET/CT . Sensitivity Specificity Author Year Pt n . % % . Yamagishi, et 2003 17 >5h Not specified 82 NA. Okumura,et 2004 22 >12h Not specified 100 91. Ishimaru, et 2005 32 >12h Not specified 100 82. Ohira, et al.

3 22 . 2008 21 >12h Not specified 88 39. Langah, et 2009 76 >18h Not specified 85 90. Tahara, et 2011 12 >12h Not specified 100 97.. FDG 5 .. Lum FDG PET/CT . 12 . 38. 38 1:07:40 PM. SUVmax . 13 .. 5g 5 13 14 . Ohira 5 . 15 Beth Israel Deaconess Medical Centre Williams 3 6 . FDG SUVmax . 14 16 12 . FDG 17 FDG 4 265kcal . Cheng 13 . 12 FDG .. <Recommendation>. FDG PET/CT . 12 FDG .. 5g . FDG 3 6 .. FDG PET/CT . Author Year Pt n . Lum, et 2002 69 Overnight fast . >6h Cheng et 2010 63 . 15h 16 . Williams, et al. 2008 161 3-6h . Wykrzykowska, et 2009 32 Overnight fast . 12h . Harisankar, et 2011 110 . 4h .. 18 . 19 20 FDG PET.

4 FDG 15 . 21 Nuutila 20 . 4700 IU Ishimaru 50 IU/kg 21 22 . FDG . 23 . FDG Ishimaru 30 14 47% . 21 .. 39. 39 1:07:40 PM.. <Recommendation>. FDG PET/CT .. HIT . HIT 5% 24 25 . 2 FDG PET FDG . FDG . 24 9 FDG PET, PET/CT 2012 28 . 3D 111 MBq 259 MBq 2 5 MBq/kg 2D 185 MBq . 444 MBq 3 7 MBq/kg FDG .. 8 . PET PET FDG . 185 555 MBq 5 15 mCi 3D 2D .. FDG PET . PET PET/CT . 555 MBq . <Recommendation>. FDG . 3D 111 MBq 259 MBq 2 5 MBq/kg 2D 185 MBq 444 MBq 3 7. MBq/kg FDG . FDG PET PET/CT . FDG . spot Author Year Pt n FDG dose . Yamagishi, et 2003 17 PET 259-370 MBq 50 min 10 min Okumura,et 2004 22 PET 200 MBq 60 min Not specified Ishimaru, et 2005 32 PET 185 MBq 45-60 min Not specified Langah, et 2009 20 PET/CT 555 MBq 60 min Not specified Tahara, et 2011 12 PET 60 min Not specified.

5 28 . FDG PET, PET/CT 2012 45 60 . PET PET/CT PET . CT PET/CT . 8 FDG 45 . 40. 40 1:07:40 PM. 45 29 . 18F . 60 .. <Recommendation>.. FDG 60 PET PET/CT PET. PET/CT . 60 . misalignment artifact . PET. PET PET/CT . PET CT misalignment .. standardized uptake value SUV 30 . PET/CT .. X X.. 8 FDG 10 30 .. FDG 10 . SUV .. <Recommendation>.. * . * . / .. 41. 41 1:07:41 PM. PET/CT CT PET misalignment artifact . 10 .. 3 .. 1 . PET CT . PET/CT CT CT PET . misalignment CT . misalignment PET CT misalignment . CT ICD . CT 31 32 . 2 .. 5 9 10 21 22 26 27 33 . 3 22 .. 3 .. SPECT .. FDG .. SPECT .. 34 . 42. 42 4:40:34 PM.. <Recommendation>.

6 CT misalignment . ICD . CT . MIP .. MIP .. 1 MIP transaxial plane . MIP . FDG . 35 36 . MIP FDG . sarcoidvasculitis . FDG .. 2 . FDG .. 2 11 diffuse, focal 3 10 none, diffuse, focal 4 21, 22, 27 none, diffuse, focal, focal on diffuse focal focal on diffuse . focal diffuse 4 . ishimaru 21 .. A FDG none . B FDG diffuse .. FDG . C FDG focal . 43. 43 1:07:41 PM. MIP . A B C D.. 21 .. FDG 37 38 . 21 22 . FDG .. D FDG focal on diffuse 27 . FDG .. C D . 100% 21 . 3 .. 23 30% II III . 39 40 . FDG . 41 . 23% 39 FDG .. 4 SPECT SPECT . 201. Tl 99mTc SPECT . FDG FDG FDG . SPECT . 40 65% 42 43 . 44. 44 1:07:42 PM. 123I BMIPP SPECT.

7 5 SUV . FDG SUV standardized uptake value . SUV PET 1kg . FDG 1ml . FDG FDG SUV . 26 Okumura 13 SUV SUV+2SD . 100% 91% 26 Tahara 17 SUV SUV SD . 100% 97% 27 . SUV SUV .. <Recommendation>.. MIP .. FDG focal focal on diffuse C D .. SPECT FDG PET .. SUV .. 1 1992 . p23 24 1993 . 2 54(9):955 961, 2006. 3 Wisneski JA, Gertz EW, Neese RA, et al.: Myocardial metabolism of free fatty acids. Studies with 14C labeled substrates in humans. The Journal of clinical investigation 1987;79:359 66. 4 Yoshinaga K, Tamaki N: Imaging myocardial metabolism. Current opinion in biotechnology 2007;18:52 9. 5 Ohira H, Tsujino I, Yoshinaga K.

8 18F Fluoro 2 deoxyglucose positron emission tomography in cardiac sarcoidosis . Eur J Nucl Med Mol Imaging 2011;38:1773 83. 6 Boellaard R, O'Doherty MJ, Weber WA et al.: FDG PET and PET/CT: EANM procedure guidelines for tumour PET imaging: version Eur J Nucl Med Mol Imaging 2010;37:181 200. 7 Delbeke D, Coleman RE, Guiberteau MJ et al. Procedure guideline for tumor imaging with 18F FDG PET/CT J Nucl Med 2006;47:885 95. 8 Machac J, Bacharach SL, Bateman TM et al.: Positron emission tomography myocardial perfusion and glucose metabolism imaging. J Nucl Cardiol 2006;13:e121 51. 9 Yamagishi H, Shirai N, Takagi M et al.: Identification of cardiac sarcoidosis with 13N NH3/18F FDG PET.

9 J Nucl Med 2003;44:1030 6. 10 Youssef G, Leung E, Mylonas I et al.: The use of 18F FDG PET in the diagnosis of cardiac sarcoidosis : a systematic review and metaanalysis including the Ontario experience. J Nucl Med 2012;53:241 8. 11 Langah R, Spicer K, Gebregziabher M, et al.: Effectiveness of prolonged fasting 18F FDG PET CT in the detection of cardiac 45. 45 1:07:42 PM. sarcoidosis . J Nucl Cardiol 2009;16:801 10. 12 Lum DP, Wandell S, Ko J, Coel MN: Reduction of myocardial 2 deoxy 2 [18F]fluoro D glucose uptake artifacts in positron emission tomography using dietary carbohydrate restriction. Molecular imaging and biology 2002;4:232 7.

10 13 Cheng VY, Slomka PJ, Ahlen M, et al.: Impact of carbohydrate restriction with and without fatty acid loading on myocardial 18F FDG. uptake during PET: A randomized controlled trial. J Nucl Cardiol 2010;17:286 91. 18. 14 Wykrzykowska J, Lehman S, Williams G et al.: Imaging of inflamed and vulnerable plaque in coronary arteries with F FDG. PET/CT in patients with suppression of myocardial uptake using a low carbohydrate, high fat preparation. J Nucl Med 2009;50:563 8. 15 Frayn KN: The glucose fatty acid cycle: a physiological perspective. Biochemical Society transactions 2003;31:1115 9. 16 Williams G, Kolodny GM: Suppression of myocardial 18F FDG uptake by preparing patients with a high fat, low carbohydrate diet.