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Advances in radionuclide imaging of cardiac sarcoidosis
V Kouranos1, A U Wells1, R Sharma2
1Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK.
Introduction:
Radionuclide imaging for the diagnosis and monitoring of cardiac involvement in sarcoidosis has advanced significantly in recent years.
Sources Of Data:
This article is based on published clinical guidelines, literature review and our collective clinical experience.
Areas Of Agreement:
Gallium-67 scintigraphy is among the diagnostic criteria for cardiac involvement in systemic sarcoidosis, and it is strongly associated with response to treatment. However, fluorine-18, 2-fluoro-deoxyglucose (FDG) positron emission tomography (PET) is now preferred both for diagnosis and for assessing prognosis.
Areas Of Controversy:
Most data are from small observational studies that are potentially biased.
Growing Points:
Quantitative imaging to assess changes in disease activity in response to treatment may lead to FDG-PET having an important routine role in managing cardiac sarcoidosis.
Areas Timely For Developing Research:
Larger prospective studies are required, particularly to assess the effectiveness of radionuclide imaging in improving clinical management and outcome.
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