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Updates on the Role of Imaging in Cardiac Sarcoidosis

  • Imaging (Q Truong, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of review

The non-specific symptom profile and subclinical nature of disease along with variable region of cardiac involvement in systemic sarcoidosis make the diagnosis particularly challenging. The yield of endomyocardial biopsy, a gold standard for diagnosis, is not high unless coupled with additional imaging modalities to detect regional involvement. This review is focused on highlighting the major recent advances in imaging modalities and diagnosis of cardiac sarcoidosis.

Recent findings

There has been much interest and increasing research focused on developing newer and improved imaging modalities to establish diagnosis. CMR and 18F- FDG-PET are now considered imaging modalities of choice in most centers worldwide, but the data comparing both methodologies head-to-head is limited. Nevertheless, novel radiotracers (i.e. 68Ga-DOTANOC, 18F-Flurpiridaz, 13N-Ammonia) and hybrid combination PET/CMR imaging are coming to spotlight with improved sensitivity and specificity for earlier detection of myocardial sarcoid.

Summary

As CMR and PET are showing increased utilization in cardiac sarcoidosis, 201Th-SPECT, 99mTc MDP SPECT, 67Ga Scintigraphy, and 82Rb PET are falling out of favor. Newer imaging modalities, radionuclide tracers, and hybrid PET/CMR combinations have been promising in better detecting cardiac sarcoidosis and are currently being evaluated in larger trials.

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References and Recommended Reading

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Authors and Affiliations

  1. Department of Internal Medicine, Kettering Medical Center, Dayton, OH, USA

    Yan Yatsynovich MD, Damian Valencia MD, Juan David Linares MD & Nathaniel Dittoe MD

  2. Department of Internal Medicine, Norwalk Hospital, Norwalk, CT, USA

    Mikhail Petrov MD & Mufti M. Rahman MD

  3. Division of Cardiovascular Medicine, Department of Internal Medicine, Kettering Medical Center, Dayton, OH, USA

    Nathaniel Dittoe MD

  4. Boonshoft School of Medicine, Department of Internal Medicine, Wright State University, Dayton, OH, USA

    Nathaniel Dittoe MD

  5. Kettering Medical Center, 3535 Southern Boulevard, Dayton, OH, 45429, USA

    Nathaniel Dittoe MD

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Yatsynovich, Y., Valencia, D., Petrov, M. et al. Updates on the Role of Imaging in Cardiac Sarcoidosis. Curr Treat Options Cardio Med 20, 74 (2018). https://doi.org/10.1007/s11936-018-0670-7

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