Advances in radionuclide imaging of cardiac sarcoidosis.

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.