Fluorodeoxyglucose F18

ABCIC

Review Article

Cardiac Sarcoidosis: The Role of Multimodal Imaging

Lara Cristiane Terra Ferreira Carreira et al. Lívia Carreira Adriana Soares Xavier de Brito

ABSTRACT

Cardiac sarcoidosis (CS) is a potentially severe manifestation of systemic sarcoidosis, associated with advanced atrioventricular block, ventricular arrhythmias, heart failure, and sudden death. Diagnosis remains challenging due to phenotypic variability and the limitations of conventional diagnostic methods. Advances in imaging techniques, especially the combination of positron emission tomography/computed tomography (PET/CT) using ¹⁸F-FDG and cardiac magnetic resonance imaging (CMR), have revolutionized the diagnostic approach and therapeutic monitoring of CS. This article reviews current concepts of CS and its diagnosis, with a focus on the role of PET/CT, the importance of appropriate patient preparation, and integration with CMR.

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ABCIC

Review Article

My Approach to Evaluation of Cardiac Masses Using FDG PET/CT

Simone Cristina Soares Brandão et al. João Marcelo Duarte Ribeiro Sobrinho Emanuel Davi Lima de Matos Leão Lara Cristiane Terra Ferreira Carreira Adriana Soares Xavier de Brito

Abstract

Cardiac masses represent solid formations of various origins, with accurate diagnosis being crucial, particularly for those of a malignant nature, which are typically associated with a worse prognosis. Given this diversity, a comprehensive approach often involves the integration of multiple imaging modalities. Conventional cardiovascular imaging techniques such as transthoracic echocardiography, magnetic resonance imaging (MRI), and cardiac tomography offer insights into anatomical features and hemodynamic implications associated with these masses. However, due to its limitations, greater precision in the etiological investigation of these masses can be achieved by combining Nuclear Medicine with complementary methods, notably positron emission tomography combined with computed tomography using fluorodeoxyglucose-Fluorine-18 (FDG PET/CT). This approach aids in effectively assessing cardiac masses’ metabolic activity, particularly when distinguishing between benign and malignant masses, guiding optimal biopsy site selection, and facilitating comprehensive staging. The Standardized Uptake Value (SUVmax) serves as a quantitative measure of FDG uptake by the mass, with elevated SUVmax values indicating malignancy. Clinical and conventional imaging data should complement the interpretation of FDG PET/CT findings for a more conclusive diagnosis. Thus, a multimodal strategy, particularly incorporating FDG PET/CT, enables a more precise differentiation between benign and malignant cardiac masses, ultimately optimizing patient management.

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ABCIC

Case Report

8F-FDG PET/CT in Diagnosis, Therapeutic Evaluation and Definition of Management in Cardiac Sarcoidosis: Learn From This Case Report

Simone Cristina Soares Brandão et al. Matheus de Araújo Lucena Christiane Wiefels Pedro Rodrigues da Silva … Claudio Tinoco Mesquita Maria Fernanda Rezende Fabio Mastrocola

Introduction

Sarcoidosis is a non-caseating granulomatous inflammatory disease of unknown etiology. The presentation can range from an asymptomatic condition with nonspecific findings on chest radiography to organ failure. Any part of the body can be affected, but the most common sites are the mediastinal lymph nodes and the lungs, followed by the skin and ocular structures such as the uvea. Other systems, such as the nervous, endocrine, gastrointestinal, urinary, musculoskeletal, and cardiovascular systems, can also be affected.

Cardiac sarcoidosis is a disease that is still under-researched in cardiology. It is related to cardiomyopathy conditions that can be confused with hypertrophic, infiltrative, or even ischemic cardiomyopathy, and it courses with ventricular arrhythmias and conduction disorders with possible progression to heart failure and/or sudden death. It is worth emphasizing that cardiac sarcoidosis is responsible for up to 35% of cases of complete atrioventricular block (CAVB) in patients under 60 years of age. These patients benefit from the implantation of a pacemaker and implantable cardioverter defibrillator (ICD). Immunosuppressive therapy is indicated to control the inflammatory process.

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Cardiac Sarcoidosis: The Role of Multimodal Imaging

ABSTRACT

My Approach to Evaluation of Cardiac Masses Using FDG PET/CT

Abstract

8F-FDG PET/CT in Diagnosis, Therapeutic Evaluation and Definition of Management in Cardiac Sarcoidosis: Learn From This Case Report

Introduction

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