UTILITY OF PET CT IN DIAGNOSING CARDIAC SARCOIDOSIS, ESPECIALLY AS A COMPLEMENTARY MODALITY TO CARDIAC MRI

Document Type

Conference Proceeding

Publication Date

4-1-2024

Publication Title

J Am Coll Cardiol

Abstract

Background Cardiac sarcoidosis (CS) is an infiltrative cardiomyopathy resulting from granulomatous inflammation. Advanced imaging with positron emission tomography (PET) and magnetic resonance imaging (MRI) has the added benefit of detecting active inflammation and fibrosis due to CS, and can guide management. Case A 59-year-old male presented with presyncope for 2 weeks. Electrocardiogram demonstrated complete heart block. Transthoracic echocardiogram demonstrated mildly reduced left ventricular ejection fraction of 50-55%. Cardiac MRI demonstrated late gadolinium enhancement involving the mid myocardial basal septum and subepicardial mid inferior wall of the left ventricle suggestive of CS (figure1). A follow-up FDG-PET demonstrated similar distribution of active myocardial inflammation. The patient was treated with prednisone. Decision-making Utility of advanced imaging is key in the setting of suspected CS. MRI brings high spatial resolution and fibrosis detection, while PET provides myocardial inflammatory information. Both modalities identify different histopathologic features of CS, hence the complimentary use of both tests in defining the need for treatment and assisting in risk stratification. Conclusion In patients with high suspicion of CS, combination of MRI and PET can help establish the diagnosis as well as identify distribution of active inflammation, and guide treatment options/prognosis. [Formula presented]

Volume

83

Issue

13

First Page

3506

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