Usefulness of PET and semiconductor SPECT as a biomarker of atral fibrillation

• Project/Area Number: 17K10443
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Radiation science
• Research Institution: Ehime University
• Principal Investigator: Miyagawa Masao 愛媛大学, 医学部附属病院, 教授 (90346685)
• Co-Investigator(Kenkyū-buntansha): 望月 輝一 愛媛大学, 医学系研究科, 教授 (80145094)
• Project Period (FY): 2017-04-01 – 2020-03-31
• Project Status: Completed (Fiscal Year 2019)
• Budget Amount: ¥3,900,000 (Direct Cost: ¥3,000,000、Indirect Cost: ¥900,000); Fiscal Year 2019: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000); Fiscal Year 2018: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2017: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000)
• Keywords: PET/CT / 心房細動 / 炎症細胞 / 剖検心 / ＦＤＧ ＰＥＴ/CT / アブレーション / FDG PET / 半導体SPECT

Outline of Final Research Achievements

Among 8233 patients who underwent FDG-PET/CT as work-up for malignancies, we identified 180 patients with atrial fibrillation (Af; 2.2%). Of those, we selected 137 patients who had fasted >12 hr before FDG injection. For quantitative analysis, we used the maximum standard uptake value(SUVmax) in the left(LA) and right atria(RA) and target-to-background ratio(TBR). The sensitivity, specificity, and positive-predictive value for detecting Af visually were 54%, 95%, and 96%, respectively; for quantitative analysis,the respective values were 66%, 76%, and 86%. Multivariate analysis showed significant associations with RA SUVmax and LA volume. The RA TBR was greater in cases with persistent Af than in those with paroxysmal Af. Pathological investigation of 4 autopsy hearts confirmed infiltration of macrophages and lymphocytes in the regions with FDG uptake. Higher atrial FDG uptake was associated with Af. PET/CT could be a useful tool for detecting local inflammation in the atria with Af

Academic Significance and Societal Importance of the Research Achievements

FDG PET検査は、国内で年間約70万件が施行されているが、97%以上が悪性腫瘍診断を目的としている。心臓大血管系の診断については、心筋への生理的FDG集積が存在するため、心サルコイドーシスや高安動脈炎など小数患者への保険適用にとどまる。心房細動(Af)を有する患者は2030年には100万人を突破し、合併症の心原性脳塞栓症も大幅増が予想される。本研究により、Afに対する腫瘍FDG PETの陽性的中率は97%と拾い上げ診断が可能で、発作性、慢性の診断、アブレーション治療効果判定にも有用であることが示された。心房への炎症細胞浸潤という病理学的検所見は今後の治療法に結び付く可能性がある。

Research Products

• [Journal Article] Clinical significance of corrected relative flow reserve derived from 13N-ammonia positron emission tomography combined with coronary computed tomography angiography. (2020)
  • Author(s): 1.Kawaguchi N, Okayama H, Kido T, Fukuyama N, Shigematsu T, Kawamura G, Hiasa G, Kazatani Y, Inoue T, Miki H, Miyagawa M, Mochizuki T.
  • Journal Title: J Nucl Cardiol. Volume: 3 Issue: 5 Pages: 1851-1860
  • DOI: 10.1007/s12350-019-01931-5
  • Peer Reviewed
• [Journal Article] Incremental diagnostic value of whole-heart dynamic computed tomography perfusion imaging for detecting obstructive coronary artery disease. (2020)
  • Author(s): Nishiyama H, Tanabe Y, Kido T, Kurata A, Uetani T, Kido T, Ikeda S, Miyagawa M, Mochizuki T.
  • Journal Title: J Cardiol. Volume: 73 Issue: 5 Pages: 425-431
  • DOI: 10.1016/j.jjcc.2018.12.006
  • Peer Reviewed / Open Access
• [Journal Article] Positron emission tomography/computed tomography detection of increased 18F-fluorodeoxyglucose uptake in the cardiac atria of patients with atrial fibrillation. (2019)
  • Author(s): Watanabe E, Miyagawa M, Uetani T, Kinoshita M, Kitazawa R, Kurata M, Ishimura H, Matsuda T, Tanabe Y, Kido T, Kido T, Kurata A, Mochizuki T.
  • Journal Title: Int J Cardiol. Volume: 283 Pages: 171-177
  • DOI: 10.1016/j.ijcard.2018.10.106
  • Peer Reviewed / Open Access
• [Journal Article] Recommendations for ¹⁸F-Fluorodeoxyglucose Positron Emission Tomography Imaging for Diagnosis of Cardiac Sarcoidosis—2018 Update (2019)
  • Author(s): Kumita S, Yoshinaga K, Miyagawa M, Momose M, Kiso K, Kasai T, Naya M.
  • Journal Title: Annals of Nuclear Cardiology Volume: 5 Issue: 1 Pages: 141-159
  • DOI: 10.17996/anc.19-00092
  • NAID: 130007699329
  • ISSN: 2189-3926, 2424-1741
  • Peer Reviewed / Open Access
• [Journal Article] Recommendations for 18F-fluorodeoxyglucose positron emission tomography imaging for diagnosis of cardiac sarcoidosis-2018 update: Japanese Society of Nuclear Cardiology recommendations. (2019)
  • Author(s): Kumita S, Yoshinaga K, Miyagawa M, Momose M, Kiso K, Kasai T, Naya M.
  • Journal Title: J Nucl Cardiol. Volume: 26 Issue: 4 Pages: 1414-1433
  • DOI: 10.1007/s12350-019-01755-3
  • Peer Reviewed
• [Journal Article] Clinical Usefulness of Coronary Flow Reserve Ratio for the Detection of Significant Coronary Artery Disease on ¹³N-Ammonia Positron Emission Tomography (2018)
  • Author(s): Kawaguchi N, Okayama H, Kawamura G, Shigematsu T, Takahashi T, Kawada Y, Hiasa G, Yamada T, Matsuoka H, Kazatani Y, Miyagawa M, Mochizuki T.
  • Journal Title: Circulation Journal Volume: 82 Issue: 2 Pages: 486-493
  • DOI: 10.1253/circj.CJ-17-0745
  • NAID: 130006320328
  • ISSN: 1346-9843, 1347-4820
  • Peer Reviewed / Open Access
• [Journal Article] Late iodine enhancement computed tomography with image subtraction for assessment of myocardial infarction. (2018)
  • Author(s): Tanabe Y, Kido T, Kurata A, Kouchi T, Fukuyama N, Yokoi T, Uetani T, Yamashita N, Miyagawa M, Mochizuki T.
  • Journal Title: Eur Radiol Volume: 28 Issue: 3 Pages: 1285-1292
  • DOI: 10.1007/s00330-017-5048-9
  • Peer Reviewed
• [Journal Article] New classification of hydronephrosis on 18F-FDG-PET/CT predicts post-operative renal function and muscle-invasive disease in patients with upper urinary tract urothelial carcinoma. (2018)
  • Author(s): Asai S, Fukumoto T, Watanabe R, Koyama K, Sawada Y, Noda T, Miura N, Yanagihara Y, Miyauchi Y, Miyagawa M, Kikugawa T, Saika T.
  • Journal Title: Jpn J Clin Oncol Volume: 48 Issue: 11 Pages: 1022-1027
  • DOI: 10.1093/jjco/hyy135
  • Peer Reviewed
• [Journal Article] Two-phase contrast injection protocol for pediatric cardiac computed tomography in children with congenital heart disease. (2018)
  • Author(s): Fukuyama N, Kurata A, Kawaguchi N, Tashiro R, Higaki T, Yokoi T, Tanabe Y, Nishiyama H, Itoh T, Kido T, Miyagawa M, Mochizuki T.
  • Journal Title: Pediatr Cardiol Volume: 39 Issue: 3 Pages: 518-525
  • DOI: 10.1007/s00246-017-1782-7
  • Peer Reviewed
• [Journal Article] Estimation of myocardial flow reserve utilizing an ultrafast cardiac SPECT: Comparison with coronary angiography, fractional flow reserve, and the SYNTAX score. (2017)
  • Author(s): Miyagawa M, Nishiyama Y, Uetani T, Ogimoto A, Ikeda S, Ishimura H, Watanabe E, Tashiro R, Tanabe Y, Kido T, Kurata A, Mochizuki T.
  • Journal Title: International Journal of Cardiology Volume: 244 Pages: 347-353
  • DOI: 10.1016/j.ijcard.2017.06.012
  • Peer Reviewed
• [Journal Article] Optimal patient preparation for detection and assessment of cardiac sarcoidosis by FDG-PET. (2017)
  • Author(s): Miyagawa M, Tashiro R, Watanabe E, Kawaguchi N, Ishimura H, Kido T, Kido T, Kurata A, Mochizuki T.
  • Journal Title: Annals of Nuclear Cardiology Volume: 3 Pages: 113-116
  • NAID: 130006191189
  • Peer Reviewed
• [Journal Article] PET/CTとSPECT/CTのストラテジー&アウトカム 3. 心筋SPECT検査による心機能の定量解析 (2017)
  • Author(s): 宮川正男, 渡部笑麗, 石村隼人, 望月輝一.
  • Journal Title: INNERVISION Volume: 32 Pages: 73-75
• [Presentation] Complete suppression of physiological FDG uptake achieved by means of more than 18 hr fasting with low carbohydrate diet in patients with cardiac sarcoidosis. (2019)
  • Author(s): Miyagawa M, Tashiro R, Watanabe E, Kawaguchi N, Ishimura H, Mochizuki T.
  • Organizer: SNMMI (Society of Nuclear Medicine & Molecular Imaging) 66th annual meeting
  • Int'l Joint Research
• [Presentation] 非虚血性心疾患の核医学: Nuclear Cardiology for Non-Ischemic Heart Disease (2019)
  • Author(s): 宮川正男
  • Organizer: 第78回 日本医学放射線学会総会
  • Invited
• [Presentation] 長時間絶食PETプロトコールで撮影した心アミロイドーシスにおけるFDG集積の検討. (2019)
  • Author(s): 岡田知久、宮川正男、川口直人、田邉裕貴、中村壮志、松田卓也、城戸倫之、城戸輝仁、倉田 聖、望月輝一.
  • Organizer: 第29回 日本心臓核医学会総会・学術大会
• [Presentation] Blood Sampling before FDG Injection Predicts Suppression of Physiological Myocardial Uptake in the Patients with Cardiac Sarcoidosis (2019)
  • Author(s): Watanabe E, Miyagawa M, Kawaguchi N, Ishimura H, Mochizuki T.
  • Organizer: 第78回 日本医学放射線学会総会
• [Presentation] Role of FDG-PET in the diagnosis of cardiac sarcoidosis. (2018)
  • Author(s): Miyagawa M.
  • Organizer: Annual Congress of East Asia Nuclear Medicine Association (EANMA 2018)
  • Int'l Joint Research / Invited
• [Presentation] 心房細動患者におけるF-18 FDG心集積についての検討. (2018)
  • Author(s): 渡部 笑麗, 宮川 正男, 平井 邦明, 横井 敬弘, 小川 遼, 川口 直人, 城戸 倫之, 城戸 輝仁, 倉田 聖, 望月 輝一.
  • Organizer: 第58回日本核医学会学術総会
• [Presentation] Characteristics of FDG uptake in the atria of patients with atrial fibrillation. (2018)
  • Author(s): Watanabe E, Miyagawa M, Hirai K, Yokoi T, Nakamura M, Kido T, Kido T, Kurata A, Mochizuki T.
  • Organizer: 第77回日本医学放射線学会総会
• [Presentation] FDG-PET検査の心臓サルコイドーシス診療における位置づけ. (2018)
  • Author(s): 宮川 正男.
  • Organizer: 第38回日本サルコイドーシス/肉芽腫性疾患学会総会
  • Invited
• [Presentation] アンモニアPETを用いたCFR ratioによる再灌流療法後の治療効果判定. (2018)
  • Author(s): 川口 直人, 宮川 正男, 望月 輝一.
  • Organizer: 第58回日本核医学会学術総会
• [Presentation] Detection of increased FDG uptake in the atria by PET/CT in patients with atrial fibrillation. (2017)
  • Author(s): Watanabe E, Miyagawa M, Yokoi T, Ogawa R, Kido T, Kido T, Kurata A, Mochizuki T.
  • Organizer: RSNA 103th Annual Meeting
  • Int'l Joint Research
• [Presentation] Incremental value of myocardial perfusion reserve for detection of multi-vessel coronary artery disease with use of a cadmium-zinc-telluride SPECT. (2017)
  • Author(s): Watanabe E, Miyagawa M, Ishimura H, Nishiyama Y, Uetani T, Tanabe Y, Kido T, Ogimoto A, Kido T, Kurata A, Mochizuki T.
  • Organizer: 2017 American Roentgen Ray Society Annual Meeting
  • Int'l Joint Research
• [Presentation] Quantitative Assessment of Cardiac FDG Uptake During a Long-term follow-up of steroid therapy in patients with cardiac sarcoidosis. (2017)
  • Author(s): Miyagawa M, Tashiro R, Watanabe E, Ogawa R, Kawaguchi N, Nakamura M, Kido T, Kurata A, Mochizuki T.
  • Organizer: RSNA 103th Annual Meeting 2017
  • Int'l Joint Research
• [Presentation] 心房細動患者におけるF-18 FDG心集積についての検討. (2017)
  • Author(s): 渡部 笑麗, 宮川 正男, 平井 邦明, 横井 敬弘, 小川 遼, 川口 直人, 城戸 倫之, 城戸 輝仁, 倉田 聖, 望月 輝一.
  • Organizer: 第57回日本核医学会学術総会
• [Presentation] Quantitative analysis of myocardial FDG uptake by PET/CT for detection and follow-up of cardiac sarcoidosis. (2017)
  • Author(s): Miyagawa M, Tashiro R, Mochizuki T.
  • Organizer: 3rd Asian Nuclear Medicine Academic Forum 2017 (ANMAF)
  • Int'l Joint Research / Invited
• [Book] Perspectives on Nuclear Medicine for Molecular Diagnosis and Integrated Therapy (2020)
  • Author(s): Miyagawa M. et al.
  • Total Pages: 25
  • Publisher: Springer
  • ISBN: 9789811508097
• [Book] 循環器疾患の画像診断 ～現状と進歩～「核医学検査を改めて知る」循環器ジャーナル2019 (2019)
  • Author(s): 宮川 正男
  • Total Pages: 7
  • Publisher: 医学書院
  • ISBN: 9784260029568