FDG uptake patterns in isolated and systemic cardiac sarcoidosis

Area of Science:

• Cardiology
• Nuclear Medicine
• Radiology

Background:

• Cardiac sarcoidosis (CS) is an inflammatory disease affecting the heart, classified as isolated (ICS) or systemic (SCS).
• FDG-PET/CT is crucial for diagnosing and monitoring CS activity and extent.

Purpose of the Study:

• To investigate pre-treatment characteristics and treatment responses in ICS versus SCS using FDG-PET/CT.
• To compare the prognoses of patients with ICS and SCS.

Main Methods:

• Retrospective analysis of FDG-PET/CT scans from 31 ICS and 91 SCS patients before and after treatment.
• Assessment of treatment response, recurrence, and major adverse cardiac events (MACE) in subsets of patients treated for over 2 years.

Main Results:

• SCS patients exhibited significantly higher SUVmax, cardiac metabolic volume (CMV), and cardiac metabolic activity (CMA) compared to ICS patients.
• Right ventricular involvement was more frequent in SCS.
• Treatment responses, recurrence rates, and MACE incidence were similar between ICS and SCS groups.

Conclusions:

• Systemic cardiac sarcoidosis presents with more active and extensive cardiac lesions than isolated cardiac sarcoidosis prior to treatment.
• Despite differing pre-treatment characteristics, ICS and SCS patients demonstrate comparable treatment responses and prognoses.