Myocardial perfusion imaging in cardiac sarcoidosis: A “sine qua non” for prognosis assessment?

Added value gated PET with phase analysis for the detection of scar burden and prognostication in cardiac sarcoidosis?

“…2 As regards perfusion and FDG-PET imaging, the typical location of resting perfusion deficits (basal segments; commonly affecting the septum or lateral wall of the left ventricle) with corresponding abnormal focal FDG-uptake, so called ''mismatch'', is widely diagnostic for active-inflammatory cardiac sarcoidosis. 2,10 Importantly, such focal regions of ''mismatch'' between perfusion and inflammation may be related to regional leukocyte infiltration with associated inflammation, edema, and/or fibrosis. Surprisingly, such regions may have maintained or normal left ventricular wall motion that contrast classical regional hypo-to-akinesis in infarcted tissue after acute coronary syndromes.…”