Cardiac F-fluorodeoxyglucose (FDG)-PET-CT plays an important role in the assessment of cardiovascular diseases. Effective management of urgent scan findings facilitates optimal patient care. We characterised the management of urgent, expected and unexpected findings in patients referred for cardiac [F]fluorodeoxyglucose integrated with computed tomography (FDG-PET-CT) at the Royal Brompton Hospital (United Kingdom). Urgent findings are escalated by the reporting physicians/radiologists raising RadAlert notifications to the referring clinician. We characterised the indications and time to management (TTM) between the RadAlert and the resulting management. As controls, we characterised the TTM of 33 urgent findings identified before the RadAlert system was implemented. Of the 1497 consecutive FDG-PET-CT scans screened (April 2021 to February 2023), 93 RadAlerts were suitable for analysis (TTM 7 days [interquartile range: 2–14]). Expected urgent findings included active cardiac sarcoidosis (56%; TTM 8 days [5–18]), heart transplant rejection (12%; 6 ± 4 days), infective endocarditis (9%; 2 days [1–12]), cardiac device infections (5%; 1 day [0–2]), acute myocarditis (2%; 5 and 14 days) and epicardial mass (1%; 1 day). TTM did not differ significantly between indications ( = 0.06). RadAlert cases had significantly shorter TTM than controls without RadAlert, = 0.001. After the RadAlerts, 81% of patients had clinical reviews, and 55% had escalation of medical/surgical therapies. Unexpected findings (total N = 45; median TTM 6 days [1–10]) included malignancies (N = 3), infections (N = 2), pneumothorax (N = 1), benign diagnosis (N = 30), unclear diagnosis (N = 5) and 4 findings disappeared on repeat imaging. Cardiac FDG-PET-CT identifies expected and unexpected findings in a range of cardiovascular diseases. Serious, unexpected findings are rare and can be effectively escalated by the RadAlert system.

中文翻译：

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18F-氟脱氧葡萄糖正电子发射断层扫描与计算机断层扫描在心血管疾病中的预期和意外紧急发现的表征和管理

心脏F-氟脱氧葡萄糖（FDG）-PET-CT在心血管疾病的评估中发挥着重要作用。对紧急扫描结果的有效管理有助于实现最佳的患者护理。我们对在英国皇家布朗普顿医院转诊接受心脏[18F]氟脱氧葡萄糖联合计算机断层扫描 (FDG-PET-CT) 的患者的紧急、预期和意外结果的处理进行了描述。报告医生/放射科医生向转诊临床医生发出 RadAlert 通知，以升级紧急发现。我们描述了 RadAlert 和最终管理之间的适应症和管理时间 (TTM)。作为对照，我们对 RadAlert 系统实施前确定的 33 项紧急发现的 TTM 进行了表征。在筛选的 1497 个连续 FDG-PET-CT 扫描中（2021 年 4 月至 2023 年 2 月），有 93 个 RadAlert 适合分析（TTM 7 天 [四分位数范围：2-14]）。预期的紧急结果包括活动性心脏结节病（56%；TTM 8 天 [5–18]）、心脏移植排斥反应（12%；6 ± 4 天）、感染性心内膜炎（9%；2 天 [1–12]）、心脏设备感染（5%；1 天 [0–2]）、急性心肌炎（2%；5 和 14 天）和心外膜肿块（1%；1 天）。适应症之间的 TTM 没有显着差异 (= 0.06)。RadAlert 病例的 TTM 明显短于没有 RadAlert 的对照，= 0.001。RadAlerts 后，81% 的患者进行了临床审查，55% 的患者升级了药物/手术治疗。意外发现（总数 N = 45；中位 TTM 6 天 [1-10]）包括恶性肿瘤 (N = 3)、感染 (N = 2)、气胸 (N = 1)、良性诊断 (N = 30)、诊断不明确(N = 5) 和 4 个结果在重复成像时消失。心脏 FDG-PET-CT 可以识别一系列心血管疾病的预期和意外发现。严重的、意外的发现很少见，并且可以通过 RadAlert 系统有效升级。