title: ¹⁸F-Fluoro-2-deoxyglucose positron emission tomography in cardiac sarcoidosis.
abstract: Cardiac sarcoidosis (CS) is a rare and potentially life-threatening disease that causes conduction disturbance, systolic dysfunction, and most notably sudden cardiac death. Accurate diagnosis of CS is thus mandatory; however, a reliable approach that enables diagnosis of CS with high sensitivity and specificity has yet to be established. Recent studies have demonstrated the promising potential of (18)F-fluoro-2-deoxyglucose positron emission tomography ((18)F-FDG PET) in the diagnosis and assessment of CS. Indeed, (18)F-FDG PET provides a wide variety of advantages over previous imaging modalities; however, there are pitfalls and limitations that should be recognized. In this review article, (1) the rationale for (18)F-FDG PET application in CS, (2) suitable pretest preparations, and (3) evaluation protocols for the (18)F-FDG PET images obtained will be addressed. In particular, sufficient suppression of physiological (18)F-FDG uptake in the heart is essential for accurate assessment of CS. Also, (4) recent studies addressing the diagnostic role of (18)F-FDG PET and (5) the clinically important differences between (18)F-FDG PET and other imaging technologies will be reviewed. For example, active sarcoid lesions and their response to steroid treatment will be better detected by (18)F-FDG PET, whereas fibrotic lesions might be shown more clearly by magnetic resonance imaging or other nuclear myocardial perfusion imaging. In the last decade, (18)F-FDG PET has substantially enhanced detection of CS; however, CS would be better evaluated by a combination of multiple modalities. In the future, advances in (18)F-FDG PET and other emerging imaging modalities are expected to enable better management of patients with sarcoidosis.
authors.affiliation: First Department of Medicine, Hokkaido University School of Medicine, N15, W7, Kita-ku, Sapporo, Hokkaido 060-8638, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Ohira
authors.forename: Ichizo
authors.initials: I
authors.lastname: Tsujino
authors.forename: Keiichiro
authors.initials: K
authors.lastname: Yoshinaga
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D009202:Cardiomyopathies / Q000000981:diagnostic imaging* / Q000178:diet therapy / Q000188:drug therapy; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D009206:Myocardium / Q000378:metabolism; D049268:Positron-Emission Tomography / Q000379:methods*; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000178:diet therapy / Q000188:drug therapy
chemical_list: D000305:Adrenal Cortex Hormones; D019788:Fluorodeoxyglucose F18