Increased FDG-PET/CT pericardial uptake identifies acute pericarditis patients at high risk for relapse

Int J Cardiol. 2018 Nov 15:271:192-194. doi: 10.1016/j.ijcard.2018.05.126. Epub 2018 May 31.

Abstract

Objectives: We aimed to evaluate the prognostic value of FDG pericardial uptake using FDG-PET/CT in patients admitted for acute pericarditis with pericardial effusion.

Methods: In this monocentric retrospective cohort study, all patients admitted for idiopathic acute pericarditis with pericardial effusion from January 2009 to December 2016 who underwent a FDG-PET/CT at diagnosis were considered. Pericardial FDG uptake was measured by generating a volume of interest to calculate the maximal standardized uptake value. The primary outcome was the pericarditis relapse rate during follow-up.

Results: FDG-PET/CT was performed 23 [7-99] days after diagnosis in 39 patients (52 [18-83] years, 43.6% of women) admitted for acute pericarditis with pericardial effusion. During a median follow-up period of 7.6 [2.4-77.2] months, 7 (17.9%) patients suffered pericarditis relapse that occurred 3.8 [1.6-14.6] months after FDG-PET CT. In the multivariable analysis, pericardial FDG uptake at diagnosis (OR: 16.6; 95% confidence interval [CI]: 1.25 to 220.8; p = 0.033) was independently associated with pericarditis relapse. Eventually, patients with pericardial FDG uptake at diagnosis had a higher recurrence rate during follow up (p = 0.047).

Conclusions: In acute pericarditis with pericardial effusion, increased FDG-PET/CT pericardial uptake is associated with a higher risk for relapse.

Keywords: Acute pericarditis; FDG-PET CT; Relapse.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Female
  • Fluorodeoxyglucose F18 / metabolism*
  • Humans
  • Male
  • Middle Aged
  • Pericardial Effusion / diagnostic imaging
  • Pericardial Effusion / metabolism
  • Pericarditis / diagnostic imaging*
  • Pericarditis / metabolism*
  • Pilot Projects
  • Positron Emission Tomography Computed Tomography / methods
  • Positron Emission Tomography Computed Tomography / trends*
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Young Adult

Substances

  • Fluorodeoxyglucose F18