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Cardiovascular Medicine
Volume 21
Issue 9
10.4414/cvm.2018.00576
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Interesting Images

A "Ring of Fire" Around the Heart: Pericarditis Detected by FDG-PET/CT

by
Giorgio Treglia
1,2,3,4,*,
Mariana Raditchkova
1,
Luca Ceriani
1 and
Luca Giovanella
1
1
Clinic of Nuclear Medicine and PET/CT Centre, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
2
Health Technology Assessment Unit, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
3
Clinical Trial Unit, Ente Ospedaliero Cantonale, 6500 Bellinzona, Switzerland
4
Department of Nuclear Medicine and Molecular Imaging, Lausanne University Hospital, 1005 Lausanne, Switzerland
*
Author to whom correspondence should be addressed.
Cardiovasc. Med. 2018, 21(9), 234; https://doi.org/10.4414/cvm.2018.00576
Submission received: 19 June 2018 / Revised: 19 July 2018 / Accepted: 19 August 2018 / Published: 19 September 2018
Browse Figure
Versions Notes
DG-PET/CT enables direct visualisation of inflammatory activity and may represent a useful tool for diagnosis, risk stratification and therapy monitoring in patients with pericarditis.
A 65-year-old man with a previous history of periaortitis was admitted to the emergency department of our hospital because of fever and intermittent chest pain, increasing in intensity and duration.
Inflammatory markers (erythrocyte sedimentation rate, C-reactive protein and leucocyte count) were abnormally increased.
The patient underwent a fluorine-18 fluorodeoxyglucose positron emission tomography / computed tomography (FDG-PET/CT) searching for the origin of this inflammatory syndrome.
PET images showed several areas of increased radiotracer uptake around the heart, corresponding to a mild pericardial effusion on CT images (Figure 1). This “ring of fire” sign on PET/CT images represents increased metabolic activity around the heart and suggested the presence of acute pericarditis.
Based on these FDG-PET/CT findings, the patient was treated with corticosteroids and colchicine with amelioration of symptoms and normalisation of serum inflammatory markers.
FDG-PET/CT offers valuable information in the assessment of cardiovascular inflammation [1,2,3]. As it enables direct visualisation of inflammatory activity, FDG-PET/CT may represent a useful tool for diagnosis, risk stratification and therapy monitoring in patients with pericarditis.

Conflicts of Interest

No financial support and no other potential conflict of interest relevant to this article was reported.

Ethical Approval

This article has been written in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

References

  1. Slart, R.H.J.A. Writing group; Reviewer group; Members of EANM Cardiovascular; Members of EANM Infection & Inflammation; Members of Committees, SNMMI Cardiovascular; Members of Council, PET Interest Group; Members of ASNC; EANM Committee Coordinator. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018, 45, 1250–69. [Google Scholar] [PubMed]
  2. Colombo, J.; Elzi, L.; Treglia, G.; Perren, A. Light in the dark: (18)F-FDG PET/CT in Staphylococcus aureus bacteremia of unknown origin. Intensive Care Med. 2018, 44, 488–9. [Google Scholar] [CrossRef] [PubMed]
  3. Kircher, M.; Lapa, C. Novel Noninvasive Nuclear Medicine Imaging Techniques for Cardiac Inflammation. Curr Cardiovasc Imaging Rep. 2017, 10, 6. [Google Scholar] [CrossRef] [PubMed]
Cardiovascmed 21 00234 g001
Figure 1. The patient underwent a fluorine-18 fluorodeoxyglucose positron emission tomography / computed tomography (FDG-PET/CT) searching for the origin of this inflammatory syndrome.
Figure 1. The patient underwent a fluorine-18 fluorodeoxyglucose positron emission tomography / computed tomography (FDG-PET/CT) searching for the origin of this inflammatory syndrome.
Cardiovascmed 21 00234 g001

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MDPI and ACS Style

Treglia, G.; Raditchkova, M.; Ceriani, L.; Giovanella, L. A "Ring of Fire" Around the Heart: Pericarditis Detected by FDG-PET/CT. Cardiovasc. Med. 2018, 21, 234. https://doi.org/10.4414/cvm.2018.00576

AMA Style

Treglia G, Raditchkova M, Ceriani L, Giovanella L. A "Ring of Fire" Around the Heart: Pericarditis Detected by FDG-PET/CT. Cardiovascular Medicine. 2018; 21(9):234. https://doi.org/10.4414/cvm.2018.00576

Chicago/Turabian Style

Treglia, Giorgio, Mariana Raditchkova, Luca Ceriani, and Luca Giovanella. 2018. "A "Ring of Fire" Around the Heart: Pericarditis Detected by FDG-PET/CT" Cardiovascular Medicine 21, no. 9: 234. https://doi.org/10.4414/cvm.2018.00576

APA Style

Treglia, G., Raditchkova, M., Ceriani, L., & Giovanella, L. (2018). A "Ring of Fire" Around the Heart: Pericarditis Detected by FDG-PET/CT. Cardiovascular Medicine, 21(9), 234. https://doi.org/10.4414/cvm.2018.00576

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