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FDG-PET/CT
and PET/MR in
Cardiovascular
Diseases
MatthieuPelletier-Galarneau
PatrickMartineau
Editors
123

FDG-PET/CT and PET/MR
in Cardiovascular Diseases

Matthieu Pelletier-Galarneau
https://t.me/medicina_free
Patrick Martineau
Editors
FDG-PET/CT and PET/
MR in Cardiovascular
Diseases

Editors
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Matthieu Pelletier-Galarneau
Montreal Heart Institute
Montréal, QC, Canada
Patrick Martineau
BC Cancer Agency
Vancouver, BC, Canada
ISBN 978-3-031-09806-2 ISBN 978-3-031-09807-9 (eBook)
https://doi.org/10.1007/978-3-031-09807-9
© The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature
Switzerland AG 2022
This work is subject to copyright. All rights are solely and exclusively licensed by the Publisher,
whether the whole or part of the material is concerned, specically the rights of translation,
reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microlms or in any
other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed.
The use of general descriptive names, registered names, trademarks, service marks, etc. in this
publication does not imply, even in the absence of a specic statement, that such names are
exempt from the relevant protective laws and regulations and therefore free for general use.
The publisher, the authors, and the editors are safe to assume that the advice and information in
this book are believed to be true and accurate at the date of publication. Neither the publisher nor
the authors or the editors give a warranty, expressed or implied, with respect to the material
contained herein or for any errors or omissions that may have been made. The publisher remains
neutral with regard to jurisdictional claims in published maps and institutional afliations.
This Springer imprint is published by the registered company Springer Nature Switzerland AG
The registered company address is: Gewerbestrasse 11, 6330 Cham, Switzerland

To Melanie, Parker, and Ella
https://t.me/medicina_free
—Patrick Martineau
To Marie-Michèle, Simone, Mathilde, Claire, and Clémence
—Matthieu Pelletier-Galarneau

Preface
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For decades now, molecular imaging has played a foundational role in the
evaluation of cardiovascular pathology focusing primarily on the assessment
of coronary artery disease and systolic function. More recently, the increasing
availability of PET imaging has led to signicant evolution in the eld of
molecular cardiovascular imaging. In particular, FDG-PET, which had long
been used for the imaging of noncardiac infection, inammation, and malignancy, has revealed itself to be immensely useful in a number of cardiovascular applications. Today, many centers offer routine cardiovascular PET
imaging for a number of indications, ranging from the evaluation of infection
(e.g., endocarditis), inammatory processes (e.g., cardiac sarcoidosis), cardiac malignancy, as well as other applications such as viability imaging.
Furthermore, technological advances have brought forth a new imaging
modality, PET/MR, for which the implications for cardiac imaging are still
being determined.
Molecular imaging has embraced the opportunities that PET imaging has
provided; however, with new roles come new challenges. The rapid growing
body of literature and the broad variety of pathologies that can now be routinely encountered pose a challenge for clinicians. This can be especially true
in nonspecialist centers where studies for such indications are less frequently
performed. With this in mind, the purpose of this book is to present a clinically oriented, up-to-date, and in-depth review of the various applications of
FDG-PET/CT and FDG-PET/MR in cardiovascular diseases, along with
high-quality clinical cases with emphasis on the current available evidence.
We envisioned creating a reference textbook that will be useful to nuclear
medicine physicians, radiologists, cardiologists, residents, postgraduate fellows, and technologists. The rst section reviews the technical basis of cardiovascular PET/CT and PET/MR imaging as well as those aspects of cardiac
metabolism relevant to cardiac PET imaging. The following chapters present
specic pathologies or indications, supported by clinical cases. The last two
chapters are collections of cases including common pitfalls and interesting
cases.
The contributing authors constitute a group of internationally recognized
experts in the eld of molecular imaging stemming from North America and
Europe. To them, we are deeply indebted. We cannot adequately express our
sincere gratitude to each who volunteered their time and effort to provide
what we believe to be a thorough yet concise textbook. We thank our mentors
who have guided us at each step of our careers. Most importantly, we dedicate
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this book to our families who have shown unagging support, and innite
patience, while we spent our evenings and weekends in ofces, eschewing
family activities so we could make a little bit more headway on “the book.”
Montréal, QC, Canada MatthieuPelletier-Galarneau
Vancouver, BC, Canada PatrickMartineau
Preface

Contents
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Part I Instrumentation and Metabolism
1 Cardiac Positron Emission Tomography Basics . . . . . . . . . . . . . . 3
Chad R. R. N. Hunter and Robert A. deKemp
2 Cardiac PET/MR Basics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
Yoann Petibon, Chao Ma, Jinsong Ouyang, and
Georges El Fakhri
3 Review of Cardiac Metabolism and FDG . . . . . . . . . . . . . . . . . . . 37
Patrick Martineau and Matthieu Pelletier-Galarneau
4 Myocardial Suppression Protocols . . . . . . . . . . . . . . . . . . . . . . . . 47
Michael T. Osborne, Kenechukwu Mezue, and Sanjay
Divakaran
Part II Inammatory and Malignant Disorders
5 Cardiac Sarcoidosis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Patrick Martineau, Matthieu Pelletier Galarneau, and
David Birnie
6 Myocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
Geneviève Giraldeau, Julia Cadrin-Tourigny,
Patrick Martineau, and Matthieu Pelletier-Galarneau
7 Large Vessel Vasculitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 89
Pieter H. Nienhuis, Elisabeth Brouwer, and
Riemer H. J. A. Slart
8 Pericardial Diseases . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 101
Matthieu Pelletier-Galarneau and Patrick Martineau
9 Ventricular Arrhythmias . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 111
Daniele Muser, Abass Alavi, and Pasquale Santangeli
10 Cardiac Tumors . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 121
Patrick Martineau and Matthieu Pelletier-Galarneau
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11 Fibrosing Mediastinitis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 141
Matthieu Pelletier-Galarneau, Stephanie Tan, Francois Harel,
and Patrick Martineau
Part III Cardiovascular Infections
12 Prosthetic Valve Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . 147
Martina Sollini, Francesco Bartoli, Roberta Zanca,
Enrica Esposito, Elena Lazzeri, Riemer H. J. A. Slart, and
Paola Anna Erba
13 Native-Valve Endocarditis . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 169
Gad Abikhzer, Jeremy Y. Levett, Igal A. Sebag, and
Matthieu Pelletier-Galarneau
14 Cardiovascular Implantable Electronic Device Infection . . . . . . 183
Besma Mahida, Jérémie Calais, and François Rouzet
15 Vascular Graft Infection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 195
Elite Arnon-Sheleg and Zohar Keidar
16 Left Ventricular Assist Device Infection . . . . . . . . . . . . . . . . . . . . 207
Chaitanya Madamanchi, Sami El-Dalati, Marty Tam,
Venkatesh L. Murthy, and Richard L. Weinberg
Contents
17 Sternal Wound Infection and Mediastinitis . . . . . . . . . . . . . . . . . 225
Matthieu Pelletier-Galarneau, Stephanie Tan, Yoan Lamarche,
Francois Harel, and Patrick Martineau
Part IV Atherosclerotic Disease
18 Atherosclerosis Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 241
Azar Radfar, Shady Abohashem, Michael T. Osborne, and
Ahmed Tawakol
19 Coronary Artery Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 255
James R. Pinney, Nandakumar Menon, and
René R. Sevag Packard
20 Viability Imaging . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 275
Kevin Emery Boczar, Christiane Wiefels, Andrew M. Crean,
Robert A. deKemp, and Rob Beanlands
Part V FDG-PET in Special Populations
21 Pediatrics Cardiovascular FDG-PET Imaging . . . . . . . . . . . . . . 301
Geneviève April, Sophie Turpin, Raymond Lambert, and
Joaquim Miró
22 FDG-PET/CT in Heart Transplant . . . . . . . . . . . . . . . . . . . . . . . . 325
Johan Van Cleemput, Daan Dierickx, and Olivier Gheysens

Contents
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xi
Part VI Variants and Cases
23 Normal Variants, Not-So-Normal Variants, and
Pitfalls of FDG-PET in Cardiovascular Imaging . . . . . . . . . . . . . 343
Ingrid Bloise, Matthieu Pelletier-Galarneau, and
Patrick Martineau
24 Cardiovascular FDG-PET Atlas of Cases . . . . . . . . . . . . . . . . . . . 353
Yousif A. Lucinian, Patrick Martineau, and
Matthieu Pelletier-Galarneau
Index . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 385
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