J Cardiovasc Imaging.  2020 Apr;28(2):79-93. 10.4250/jcvi.2019.0103.

Myocardial Positron Emission Tomography for Evaluation of Cardiac Sarcoidosis: Specialized Protocols for Better Diagnosis

Affiliations
  • 1Department of Cardiology, Cardiovascular Center, Seoul National University Bundang Hospital, Seongnam, Korea
  • 2Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
  • 3Department of Nuclear Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Korea
  • 4Department of Nuclear Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
  • 5Institute of Radiation Medicine, Medical Research Center, Seoul National University, Seoul, Korea

Abstract

Sarcoidosis is a multisystemic granulomatous disease of unknown etiology with various clinical presentations depending on the organs involved. Since cardiac sarcoidosis (CS) portends a higher risk of morbidity and mortality, early diagnosis and aggressive medical treatment are essential to improve the prognosis. 18F-Fluorodeoxyglucose (FDG) positron emission tomography (PET) has emerged as an important tool with practical advantages in assessing disease activity and monitoring the treatment response in patients with CS. While it has high sensitivity, it also has great variability in specificity, probably due to normal physiologic myocardial FDG uptake, which interferes with the evaluation and follow-up of CS using FDG-PET. This review details the technical aspects of FDG-PET imaging for evaluating and diagnosing CS, assessing disease activity, and monitoring therapeutic response.

Keyword

Cardiac sarcoidosis; Multimodality imaging; Myocardial positron emission tomography; Extended fasting; High-fat low-carbohydrate diet
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