Diagnosis and monitoring of cardiac sarcoidosis with delayed-enhanced MRI and 18F-FDG PET-CT

Matthews, Robert; Bench, Travis; Meng, Hong; Franceschi, Dinko; Relan, Nand; Brown, David L.

doi:10.1007/s12350-012-9550-9

Cited by 22 publications

(8 citation statements)

References 2 publications

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“…Meta-analysis of PET-CT imaging has shown a pooled sensitivity and specificity of 89% and 78%, respectively, percentages that are comparable to MRI2 and replicated in early stages of disease 12. Beyond its role in detection of disease, 18F-FDG PET-CT shows superiority to MRI as a tool to guide therapy, as it is able to assess disease activity 10. This aids decision to initiate immunosuppressive therapy as levels of disease activity on imaging correlate with risk of VT and sudden cardiac death 13.…”

Section: Discussionmentioning

confidence: 99%

Undiagnosed cardiac sarcoidosis presenting as complete heart block and ventricular arrhythmia

et al. 2015

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SUMMARYCardiac involvement in sarcoidosis has been reported to be as high as 50% of cases and it is well documented that it is associated with a poorer prognosis. Early recognition and treatment is key to reducing the risk of fatal arrhythmias and heart failure. We report a case of undiagnosed systemic sarcoidosis in a young man who initially presented to the emergency department with complete heart block in the context of preserved biventricular systolic function, and then again with ventricular tachycardia and moderately impaired left ventricular systolic function. We discuss how 18F-fluorodeoxyglucose positron emission tomography with CT was used for accurate diagnosis and how its role in the management of sarcoidosis has expanded with recent evidence suggesting it to be a mainstay of management and disease monitoring in cardiac sarcoidosis. BACKGROUND

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Section: Discussionmentioning

confidence: 99%

Undiagnosed cardiac sarcoidosis presenting as complete heart block and ventricular arrhythmia

et al. 2015

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“…PET/CT with 18 FDG is a key technique to diagnose active cardiac sarcoidosis 88,[119][120][121][122][123][124][125] (►Figs. 2--6).…”

Section: Positron Emission Tomography/computed Tomographymentioning

confidence: 99%

“…117 Overall sensitivity of CMR for cardiac sarcoidosis ranges from 75 to > 95%, with specificities of $75 to 80%. 121,141,157,[159][160][161] In addition to its value in diagnosing cardiac sarcoidosis, CMR may serve as a prognostic indicator for severity of disease. 147,148,162 In a review of 61 consecutive patients with cardiac sarcoidosis seen in the Netherlands from 2002 to 2012, CMR was performed in 37 patients.…”

Section: Gadolinium-enhanced Cardiac Magnetic Resonance Imagingmentioning

confidence: 99%

Cardiac Involvement in Sarcoidosis: Evolving Concepts in Diagnosis and Treatment

Sayah

Bradfield²,

Moriarty

et al. 2017

Semin Respir Crit Care Med

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“…18F-FDG uptake into inflammatory cells has been validated in an autopsy study [110] and small clinical studies suggest that 18F-FDG PET has a higher sensitivity (up to 100%) and better spatial resolution for CS than technetium-99m, thallium-201 or gallium-67. 18-FDG PET scanning has a sensitivity comparable with CMR late-gadolinium-enhanced imaging in the detection of CS, albeit at the expense of specificity which is reported as low as 38.5% [79, [111][112][113]. Recent studies have used both 18-FDG and N13 ammonia (N13-NH 3 ) PET scanning or PET and thallium-201 or technetium-99m scintigraphy to assess perfusion-metabolism mismatch in active CS (FIGURE 7) [114,115].…”

Section: Nuclear Imaging In Csmentioning

confidence: 99%

“…Only a small number of case reports [113,115,[129][130][131][132][133][134] and a single study of 21 patients [79] have compared the use of both 18F-FDG PET and CMR in CS and suggest that they provide complementary information in disease assessment (FIGURE 6). Hybrid PET/MR is a novel hybrid modality that enables an integrated highresolution assessment of morphology, function and tissue characterization alongside molecular, metabolic and perfusion imaging but at lower radiation dose than PET/CT.…”

Section: Combined Pet and Cmr Evaluationmentioning

confidence: 99%

Improving the diagnostic accuracy for detecting cardiac sarcoidosis

Wicks

Menezes

Elliott

2015

Expert Review of Cardiovascular Therapy

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Cardiac sarcoid is a potentially fatal condition that presents with a wide range of clinical manifestations including conduction abnormalities, tachyarrhythmias, congestive heart failure, cardiomyopathy and sudden cardiac death. Small observational registries and non-comparative studies have described clinical evidence of cardiac involvement in 5% of patients with systemic sarcoid, yet autopsy studies suggest prevalence as high as 79%. This suggests that cardiac sarcoidosis (CS) is underdiagnosed in everyday clinical practice. The scarcity of data and lack of consensus on the most appropriate methods for detecting, monitoring and treating CS presents a significant diagnostic and therapeutic challenge. This review explores the potential impact of novel strategies, including multimodality imaging, on the diagnostic accuracy for detecting CS and treatment.

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Diagnosis and monitoring of cardiac sarcoidosis with delayed-enhanced MRI and 18F-FDG PET-CT

Cited by 22 publications

References 2 publications

Undiagnosed cardiac sarcoidosis presenting as complete heart block and ventricular arrhythmia

Undiagnosed cardiac sarcoidosis presenting as complete heart block and ventricular arrhythmia

Cardiac Involvement in Sarcoidosis: Evolving Concepts in Diagnosis and Treatment

Improving the diagnostic accuracy for detecting cardiac sarcoidosis

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