Module 15. Cardiac Sarcoid PET Imaging Clinical Data-Cardiac Sarcoid PET Imaging Clinical Data (Slides)

Cardiac Sarcoid PET Imaging Clinical Data (Slides)

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Cardiac sarcoidosis (CS) is clinically evident in approximately 20% of patients with sarcoidosis, with subclinical involvement in up to 70%. It is one of the major causes of death in patients with sarcoidosis, with cardiac symptoms often being non-specific or absent. Non-perfusion PET imaging with FDG-PET can be used for the diagnosis, prognosis, and response to treatment of CS. The optimal patient preparation for FDG-PET imaging includes prolonged fasting following a low carbohydrate diet and avoiding certain medications. Interpretation of FDG-PET requires different strategies than perfusion imaging, with visual examination of normalized and angle-corrected images and quantification using standard uptake values (SUV). <br /><br />Identifying extra-cardiac sarcoidosis is critical in the evaluation of CS. This can be done through various methods, including chest radiograph, skin exam, ophthalmological evaluation, and laboratory tests such as calcium, vitamin D, and sIL2-R levels. <br /><br />FDG-PET has high utility in the diagnostic evaluation of CS, as well as determining the necessity and titration of immunosuppressive therapy. Several consensus documents outline the role of PET/CT in cardiac sarcoid detection and monitoring therapy. Case studies have shown the effectiveness of FDG-PET in identifying multi-focal cardiac FDG uptake and guiding treatment decisions. Prednisone is often prescribed as the initial treatment for CS, with the possibility of adding immunosuppression if necessary. <br /><br />In conclusion, FDG-PET imaging with careful patient preparation and interpretation strategies can be highly useful in the diagnosis, prognosis, and treatment of cardiac sarcoidosis.

Keywords

Cardiac sarcoidosis

sarcoidosis

non-perfusion PET imaging

FDG-PET

diagnosis

prognosis

response to treatment

patient preparation

immunosuppressive therapy

prednisone