skip to main content

Title: Gallium-67 imaging in patients with dilated cardiomyopathy and biopsy-proven myocarditis

Current standards for detection of myocarditis in a clinical setting rely on endomyocardial biopsy for accurate diagnosis. With this technique a subset of patients with dilated cardiomyopathy show unsuspected myocarditis histologically. Endomyocardial biopsy, despite its specificity, may lack sensitivity due to sampling error if the inflammation is patchy or focal. Therefore, inflammation-sensitive radioisotopic imaging may be a useful adjunct in the diagnosis of myocarditis. This study was designed to evaluate the applicability of gallium-67 (67Ga) myocardial imaging as an adjunct to endomyocardial biopsy in the diagnosis of myocarditis. Sixty-eight consecutive patients referred for evaluation of dilated cardiomyopathy underwent 71 parallel studies with 67Ga imaging and biopsies that served as the basis of comparison for this study. Histologic myocarditis was identified in 8% of biopsy specimens. Clinical and hemodynamic parameters could not be used to predict the presence of myocarditis. Five of six biopsy samples (87%) with myocarditis showed dense 67Ga uptake, whereas only nine of 65 negative biopsy samples (14%) were paired with equivocally positive 67Ga scans. The single patient with myocarditis and no myocardial 67Ga uptake had dense mediastinal lymph node uptake that may have obscured cardiac uptake. The incidence of myocarditis on biopsy with a positive 67Ga scanmore » was 36% (5/14); however, the incidence of myocarditis with a negative 67Ga scan was only 1.8% (1/57). Follow-up scans for three patients showed close correlation of 67Ga uptake with myocarditis on biopsy. In conclusion 67Ga may be a useful screening test for identifying patients with a high yield of myocarditis on biopsy, and serial scans may eliminate the need for frequent biopsies in patients with proven myocarditis.« less
Authors:
; ; ; ; ;
Publication Date:
OSTI Identifier:
6541253
Resource Type:
Journal Article
Resource Relation:
Journal Name: Circulation; (United States); Journal Volume: 70:1
Research Org:
Loyola Univ. Medical Center, Maywood, IL
Country of Publication:
United States
Language:
English
Subject:
62 RADIOLOGY AND NUCLEAR MEDICINE; CARDIOVASCULAR DISEASES; DIAGNOSIS; GALLIUM 67; UPTAKE; HEART; RADIOISOTOPE SCANNING; BIOPSY; INFLAMMATION; MYOCARDIUM; PATIENTS; BETA DECAY RADIOISOTOPES; BODY; CARDIOVASCULAR SYSTEM; COUNTING TECHNIQUES; DAYS LIVING RADIOISOTOPES; DIAGNOSTIC TECHNIQUES; DISEASES; ELECTRON CAPTURE RADIOISOTOPES; GALLIUM ISOTOPES; INTERMEDIATE MASS NUCLEI; ISOTOPES; MUSCLES; NUCLEI; ODD-EVEN NUCLEI; ORGANS; PATHOLOGICAL CHANGES; RADIOISOTOPES; SYMPTOMS 550601* -- Medicine-- Unsealed Radionuclides in Diagnostics