High-fat diet improves diagnostic imaging of cardiac sarcoidosis

A new study may aid in improving the analysis of cardiac sarcoidosis through improved diagnostic imaging outcomes.

Researchers at the University of Illinois at Chicago found that if patients consume a high fat, low-sugar diet 72 hours prior to diagnostic imaging, the identification rate of cardiac sarcoidosis was significantly enhanced.

Cardiac sarcoidosis is an inflammatory disorder that strikes multiple organs also contains higher rates of identification among African Americans.

“Up until today, investigation consists of expert opinion based on the outcomes of several testing techniques including imaging,” Dr. Yang Lu, assistant professor of radiology in the UIC College of Medicine and corresponding author of the analysis, . “But what these scans reveal is often ambiguous, and thus using them to definitively diagnose prostate sarcoidosis is debatable. There’s really currently no gold standard for diagnosing prostate sarcoidosis.”

Diagnostic imaging such as positron emission topography, or PET scans, and computed tomography, or CT scans, are utilized to diagnose cardiac sarcoidosis by having patients exude a short-term radioactive tracer fludeoxyglucose, or FDG, however the outcomes are often hard to interpret.

This is due to FDG, that is similar to glucose, focusing on cells using very high metabolic rates which use plenty of glucose for energy such as cancer cells and neurons. Cells impacted by inflammation such as these discovered in cardiac sarcoidosis stand out more clearly in imaging tests.

Doctors were having patients eat high fat, low-sugar diets for a 24-hour interval before scans because healthy heart cells utilize the abundant fat for gas, therefore cells influenced by disease which use sugar are simpler to see. However, when physicians used this method, they weren’t getting the results they wanted.

“When we employed this process, we noticed that the results weren’t satisfactory,” Lu explained. “The erratic uptake of FDG by healthy gut cells makes the scans difficult to read.”

But a sudden discovery was made if a patient showed up a day late due to their scheduled scan.

“The patient was after the high fat, low-sugar daily diet for two days at that point instead of the usual 24 hours,” Lu said, adding that if the patient was scanned, the areas where the center picked up FDG were clearer and revealed active cardiac sarcoidosis.

“More excitingly, these abnormal areas were in precisely the exact same location as abnormal findings from the patient’s coronary MRI, which is indicative of cardiac sarcoidosis. We were very confident that this patient did, really, have cardiac sarcoidosis.”

The inadvertent discovery lead to the study of 215 tests from 207 patients at the University of Illinois Hospital in 2014 and 2015.

The patients have been put into two groups by the consumption of high fat, low-sugar diets for 24 hours prior to imaging along with 72 hours prior to imaging. The outcomes showed 42 percent of individuals in the 24-hour diet category had indeterminate results compared to just 4 percent of individuals in the 72-hour diet group.

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