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

J Nucl Cardiol. 2018 Jun;25(3):785-794. doi: 10.1007/s12350-016-0616-y. Epub 2016 Sep 8.


Objective: 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.

Methods: 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.

Results: 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).

Conclusion: In patients with suspected myocarditis, FDG-PET is in good agreement with CMR findings.

Keywords: Fluorodeoxyglucose (FDG); PET imaging; PET/MR imaging; cardiovascular magnetic; myocarditis; resonance imaging.

MeSH terms

  • Adult
  • Contrast Media
  • Feasibility Studies
  • Female
  • Fluorodeoxyglucose F18*
  • Gadolinium
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Multimodal Imaging
  • Myocarditis / diagnostic imaging*
  • Positron-Emission Tomography*
  • Prospective Studies
  • Radiopharmaceuticals*


  • Contrast Media
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • Gadolinium