Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

Riemer H J A Slart; Andor W J M Glaudemans; Olivier Gheysens; Mark Lubberink; Tanja Kero; Marc R Dweck; Gilbert Habib; Oliver Gaemperli; Antti Saraste; Alessia Gimelli; Panagiotis Georgoulias; Hein J Verberne; Jan Bucerius; Christoph Rischpler; Fabien Hyafil; Paola A Erba; 4Is Cardiovascular Imaging: a joint initiative of the European Association of Cardiovascular Imaging (EACVI); European Association of Nuclear Medicine (EANM)

doi:10.1007/s00259-020-05066-5

Procedural recommendations of cardiac PET/CT imaging: standardization in inflammatory-, infective-, infiltrative-, and innervation (4Is)-related cardiovascular diseases: a joint collaboration of the EACVI and the EANM

Eur J Nucl Med Mol Imaging. 2021 Apr;48(4):1016-1039. doi: 10.1007/s00259-020-05066-5. Epub 2020 Oct 27.

Authors

Riemer H J A Slart^{1

2

3}, Andor W J M Glaudemans⁴, Olivier Gheysens⁵, Mark Lubberink⁶, Tanja Kero^{6

7}, Marc R Dweck⁸, Gilbert Habib^{9

10}, Oliver Gaemperli¹¹, Antti Saraste^{12

13}, Alessia Gimelli¹⁴, Panagiotis Georgoulias¹⁵, Hein J Verberne¹⁶, Jan Bucerius¹⁷, Christoph Rischpler¹⁸, Fabien Hyafil^{19

20}, Paola A Erba^{4

21

22}; 4Is Cardiovascular Imaging: a joint initiative of the European Association of Cardiovascular Imaging (EACVI); European Association of Nuclear Medicine (EANM)

Affiliations

¹ Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. r.h.j.a.slart@umcg.nl.
² Medical Imaging Centre, Department of Nuclear medicine & Molecular Imaging (EB50), University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9700 RB, Groningen, The Netherlands. r.h.j.a.slart@umcg.nl.
³ Faculty of Science and Technology Biomedical, Photonic Imaging, University of Twente, Enschede, The Netherlands. r.h.j.a.slart@umcg.nl.
⁴ Medical Imaging Centre, Department of Nuclear Medicine & Molecular Imaging, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
⁵ Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc, Brussels, Belgium.
⁶ Department of Surgical Sciences/Radiology, Uppsala University, Uppsala, Sweden.
⁷ Medical Imaging Centre, Uppsala University Hospital, Uppsala, Sweden.
⁸ British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
⁹ Cardiology Department, APHM, La Timone Hospital, Marseille, France.
¹⁰ Aix Marseille Université, IRD, APHM, MEPHI, IHU-Méditerranée Infection, Marseille, France.
¹¹ HeartClinic, Hirslanden Hospital Zurich, Hirslanden, Switzerland.
¹² Turku PET Centre, Turku University Hospital, University of Turku, Turku, Finland.
¹³ Heart Center, Turku University Hospital, Turku, Finland.
¹⁴ Fondazione Toscana G. Monasterio, Pisa, Italy.
¹⁵ Department of Nuclear Medicine, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Larissa, Greece.
¹⁶ Department of Radiology and Nuclear Medicine, Amsterdam UMC, location AMC, University of Amsterdam, Amsterdam, The Netherlands.
¹⁷ Department of Nuclear Medicine, Georg-August University Göttingen, Göttingen, Germany.
¹⁸ Department of Nuclear Medicine, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
¹⁹ Department of Nuclear Medicine, DMU IMAGINA, Georges-Pompidou European Hospital, Assistance Publique - Hôpitaux de Paris, University of Paris, F75015 Paris, France.
²⁰ PARCC, INSERM, University of Paris, F-75006 Paris, France.
²¹ Department of Nuclear Medicine, University of Pisa, Pisa, Italy.
²² Department of Translational Research and New Technology in Medicine, University of Pisa, Pisa, Italy.

Abstract

With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [¹⁸F]FDG, but 4Is PET radiopharmaceuticals beyond [¹⁸F]FDG are also described in this document. Whilst these novel tracers are currently mainly applied in early clinical trials, some multicenter trials are underway and we foresee in the near future their use in clinical care and inclusion in the clinical guidelines. Finally, PET/MR applications in 4Is cardiovascular diseases are also briefly described. Diagnosis and management of 4Is-related cardiovascular diseases are generally complex and often require a multidisciplinary approach by a team of experts. The new standards described herein should be applied when using PET/CT and PET/MR, within a multimodality imaging framework both in clinical practice and in clinical trials for 4Is cardiovascular indications.

Keywords: 4Is; Cardiovascular diseases; PET/CT; Procedural recommendations.

Publication types

Multicenter Study
Research Support, Non-U.S. Gov't

MeSH terms

Cardiovascular Diseases* / diagnostic imaging
Fluorodeoxyglucose F18
Humans
Positron Emission Tomography Computed Tomography*
Positron-Emission Tomography
Radiopharmaceuticals
Reference Standards
Tomography, X-Ray Computed

Substances

Radiopharmaceuticals
Fluorodeoxyglucose F18