Feasibility of FDG-PET in myocarditis: Comparison to CMR using integrated PET/MRI

Besides cardiac sarcoidosis, fdg-pet is rarely used in the diagnosis of myocardial inflammation, while cardiac mri (cmr) is the actual imaging reference for the workup of myocarditis. using integrated pet/mri in patients with suspected myocarditis, we prospectively compared fdg-pet to cmr and the feasibility of integrated fdg-pet/mri in myocarditis. a total of 65 consecutive patients with suspected myocarditis were prospectively assessed using integrated cardiac fdg-pet/mri. studies comprised t2-weighted imaging, late gadolinium enhancement (lge), and simultaneous pet acquisition. physiological glucose uptake in the myocardium was suppressed using dietary preparation. fdg-pet/mri was successful in 55 of 65 enrolled patients: two patients were excluded due to claustrophobia and eight patients due to failed inhibition of myocardial glucose uptake. compared with cmr (lge and/or t2), sensitivity and specificity of pet was 74% and 97%. overall spatial agreement between pet and cmr was κ = 0.73. spatial agreement between pet and t2 (κ = 0.75) was higher than agreement between pet and lge (κ = 0.64) as well as between lge and t2 (κ = 0.56). in patients with suspected myocarditis, fdg-pet is in good agreement with cmr findings.