physiological myocardial 18f-fdg uptake pattern in oncologic pet/ct: comparison with findings in cardiac sarcoidosis

Objective(s): physiological myocardial 18f-fluorodeoxyglucose (18f-fdg) uptake in oncologic positron emission tomography (pet)/computed tomography (ct) is commonly observed with multiple variations under clinical fasting conditions. the purpose of the present study was to evaluate physiological myocardial 18f-fdg uptake pattern by comparing with the results in cardiac sarcoidosis. methods: a total of 174 examinations in 174 patients without cardiac disease and 27 examinations in 17 patients with cardiac sarcoidosis were performed. the polar map images generated from 18f-fdg pet/ct data were visually assessed as “basal ring,” “focal,” and “focal on diffuse” patterns. semi-quantitative analysis was also performed using the regional relative 18f-fdg uptake (% uptake). results: on visual analysis, the “focal on diffuse” pattern was the most common in both examinations (43% and 59%, respectively). the physiological % uptake in the lateral and basal septal walls tended to be higher. subgroup analysis showed significantly higher uptake in the mid-wall and left circumflex territory. in cardiac sarcoidosis patients, there was a significant difference only between segments 2 and 15 (p=0.04). no significant differences were observed between the base-mid apical territory and coronary artery branch territory. conclusion: high 18f-fdg uptake in the basal septal walls is likely to be observed as both physiological uptake in patients without cardiac disease and pathological uptake in patients with cardiac sarcoidosis.