FDG PET-CT findings of extra-thoracic sarcoid are associated with cardiac sarcoid: A rationale for using FGD PET-CT for cardiac sarcoid evaluation



This retrospective study investigates the relationship between cardiac and extra-thoracic sarcoid findings on FDG PET-CT using a 72-hour pretest high-fat, high-protein, and very low-carbohydrate (HFHPVLC) diet.

Patients and methods

A total of 196 consecutive FDG PET-CT scans with 72-hour HFHPVLC diet preparation were performed between December 2014 and December 2015 in known sarcoid patients. Of these scans, 5 were excluded for non-adherence to diet preparation or underlying cancer. Cardiac and extra-thoracic sarcoid lesions were categorized and measured for radiotracer uptake.


A total of 188 patients had 191 eligible FDG PET/CT scans (3 follow-up scans), of which there were 20 (10%) positive, 6 indeterminate (3%), and 165 (86%) negative for CS. Among the 20 scans positive for CS, 8 (40%) had findings of both cardiac and extra-thoracic sarcoid.


Our study shows that 40% of CS patients also have FDG PET-CT findings of extra-thoracic sarcoid. This makes an intriguing case for FDG PET-CT use with pretest diet prep over cardiac MRI (CMR) for cardiac sarcoid evaluation, given that CMR is likely to overlook these extra-thoracic sites of disease.

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High-fat, high-protein, and very low-carbohydrate


Cardiac sarcoid


Cardiac MRI


Institutional review board


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Corresponding author

Correspondence to Yang Lu MD, PhD.

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All the authors, Darshan C. Patel, Senthil S. Gunasekaran, Christopher Goettl, Nadera J. Sweiss, and Yang Lu, state that they have nothing to disclose.

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Patel, D.C., Gunasekaran, S.S., Goettl, C. et al. FDG PET-CT findings of extra-thoracic sarcoid are associated with cardiac sarcoid: A rationale for using FGD PET-CT for cardiac sarcoid evaluation. J. Nucl. Cardiol. 26, 486–492 (2019). https://doi.org/10.1007/s12350-017-0962-4

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  • Cardiac
  • Extra-thoracic
  • Sarcoid
  • Sarcoidosis