Advanced cardiovascular imaging for the evaluation of cardiac sarcoidosis

J Nucl Cardiol. 2019 Feb;26(1):188-199. doi: 10.1007/s12350-018-01488-9. Epub 2018 Nov 2.

Abstract

Cardiac sarcoidosis (CS) remains an intriguing infiltrating disorder and one of the most important forms of inflammatory cardiomyopathy. Identification of patients with CS is of extreme importance because they are at higher risk of sudden death, and heart-failure progression. And while it remains a diagnostic conundrum, a great amount of experience has been accumulated over the last decade with the advent of fluorine-18 fluorodeoxyglucose positron emission tomography and cardiac magnetic resonance with late gadolinium enhancement imaging. They have both proven to be advanced imaging techniques that provide important, and often complementary, diagnostic and prognostic information for the management of CS. However, they have also shown to have limitations, and, thus, there is a continued need for developing more specific imaging probes for identifying cardiac inflammation. The aim of the present manuscript is to provide the reader with a better understanding of the histopathology of the disease, how this potentially relates to noninvasive imaging detection, and the best strategies available for the diagnosis and management of patients with CS.

Keywords: Cardiovascular imaging; F-18 fluorodeoxyglucose; cardiac MRI; inflammation; sarcoidosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Algorithms
  • Cardiology / methods*
  • Cardiology / trends
  • Cardiomyopathies / diagnostic imaging*
  • Disease Progression
  • Fluorodeoxyglucose F18
  • Heart Failure / diagnostic imaging
  • Humans
  • Immunosuppressive Agents / metabolism
  • Inflammation
  • Nuclear Medicine / methods
  • Nuclear Medicine / trends
  • Positron-Emission Tomography
  • Prognosis
  • Sarcoidosis / diagnostic imaging*

Substances

  • Immunosuppressive Agents
  • Fluorodeoxyglucose F18