FDG PET/CT of Inflammatory Cardiovascular Disease

Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Cardiac-Interventional Radiography: 1.50
Procedures: 1.50
Diagnostic and Conduction System Studies: 1.50

Computed Tomography: 1.50
Procedures: 1.50
Neck and Chest: 1.50

Nuclear Medicine Technology: 2.50
Procedures: 2.50
Cardiac Procedures: 2.50

Registered Radiologist Assistant: 2.50
Procedures: 2.50
Thoracic Section: 2.50

Outline

1. Introduction
2. FDG PET/CT Protocol
3. Myocardial Disease
   1. Sarcoidosis
   2. Myocarditis
4. Pericardial and Epicardial Disease
   1. Pericarditis
   2. Epicarditis
5. Vascular Disease
   1. Atherosclerosis
   2. Vasculitis
6. Summary

Objectives

Upon completion of this course, students will:

1. be familiar with the affects inflammatory disorders have on the cardiovascular system
2. be able to identify the symptoms of vasculitis
3. list the advantages of FDG PET/CT to detect inflammatory processes
4. be familiar with the imaging modalities traditionally used to diagnose cardiac disease
5. be familiar with the established role of FDG PET/CT in the clinical setting
6. be able to identify the radionuclide used in FDG PET/CT
7. be familiar with the energy of PET photons
8. know the physical half-life of ¹⁸F
9. identify the normal distribution of FDG in healthy myocardium
10. identify the primary factor that determines FDG uptake in the myocardium
11. be familiar with the differences of FDG distribution in the ventricles of the heart
12. identify the fasting time necessary to reduce normal FDG myocardial uptake
13. identify the causes of inflammatory cardiomyopathy
14. know which imaging modalities provide a more direct assessment of infiltrative processes within the myocardium
15. be familiar with the potential limitations of using MRI when imaging sarcoidosis patients
16. identify the testing characteristics of the cardiac biomarker CK-MB for diagnosis of myocarditis
17. be familiar with the effects of radiation therapy or chemotherapy on FDG uptake in the myocardium
18. identify which class of drugs have a cardiotoxic effect
19. be familiar with the most common cardiovascular diseases
20. identify what is currently the most sensitive and specific cardiac biomarker for myocardial damage
21. understand the imaging features of pericarditis using FDG PET/CT
22. know the imaging modality that is best suited for detecting pericarditis
23. be familiar with the manifestations of epipericarditis
24. identify the treatment for epipericardial fat necrosis
25. be familiar with the most common cause of myocarditis in North America and Europe
26. be familiar with the “gold standard” for definitively diagnosing myocarditis
27. know what modality is considered the first-choice for diagnosing myocardial disease
28. be familiar with radionuclides that have been used for inflammation or infection of the myocardium
29. be familiar with the CMR imaging techniques recommended for diagnosing myocarditis
30. identify the vessel diameter most commonly seen when atherosclerosis is visualized on FDG PET/CT
31. be familiar with the most common large cell vasculitides
32. identify which population is most affected by Takayasu arteritis
33. be familiar with the specificity of FDG PET/CT for detecting large vessel vasculitis
34. understand the classification of vasculitis
35. be familiar with the laboratory test results indicative of active vasculitis