Diagnostic and Prognostic Value of Myocardial Scintigraphy With Thallium-201 and Gallium-67 in Cardiac Sarcoidosis

Joint SNMMI–ASNC expert consensus document on the role of 18F-FDG PET/CT in cardiac sarcoid detection and therapy monitoring

“…41,42 Although not extensively evaluated, combined 99m Tc-based or 201 Tl-plus- 67 Ga scintigraphy may have a higher diagnostic sensitivity than that of the individual tracers alone. 43,44 Furthermore, a pattern of absence of 67 Ga uptake associated with at least a moderately severe 99m Tc or 201 Tl perfusion defect may represent fibrosis in CS and is less likely to respond to immunosuppressive treatment. 44 The higher radiation exposure from 67 Ga, combined with its low contrast resolution, has limited its use in North America for the evaluation of CS.…”

“…43,44 Furthermore, a pattern of absence of 67 Ga uptake associated with at least a moderately severe 99m Tc or 201 Tl perfusion defect may represent fibrosis in CS and is less likely to respond to immunosuppressive treatment. 44 The higher radiation exposure from 67 Ga, combined with its low contrast resolution, has limited its use in North America for the evaluation of CS. Nevertheless, 67 Ga scintigraphy remains in the JMHW and HRS criteria for the diagnosis of CS and may have a potential role for monitoring disease activity and response to therapy.…”

Cardiac sarcoidosis: A review on the work-up and management

“…Gallium-67 scintigraph, being positive only in the active stage of the disease, reflects the activity of sarcoid granulomas. Gallium-67 scintigraphy well correlates with a better response to corticosteroid treatment [20,21]. Combined use of both 99-mTc sestamibi and gallium-67 increases the diagnostic feasibility for CS.…”

Diagnostic and Therapeutic Management of Cardiac Sarcoidosis -Application of High Resolution Electrocardiography

“…Gallium uptake in the heart indicates active inflammation, which is a useful finding in predicting the response to corticosteroid therapy (Okayama et al 1995). Futamatsu et al recently reported that gallium-67 scintigraphy is useful for evaluation of CS with ventricular tachycardia (VT) (Futamatsu et al, 2006).…”

“…Thus, Gallium-67 uptake is highly specific to inflammatory disease and a useful for detection of disease activity of cardiac sarcoidosis. Meanwhile, the main disadvantage is lack of sensitivity (20%, 36%) (Okayama et al, 1995;Kiuchi et al, 2007).…”