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Assessment of Cardiac Sarcoidosis: FDG PET and BMIPP SPECT

  • Nuclear Cardiology (V Dilsizian, Section Editor)
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Abstract

Purpose of Review

Cardiac sarcoidosis (CS) is an inflammatory disease of unknown etiology that can lead to life-threatening arrhythmias, heart failure, and death. Advanced cardiac imaging modalities have improved the clinician’s ability to detect this disease. The purpose of this review is to discuss the recent evidence of cardiac metabolic imaging as assessed by [18F]FDG PET and [123I]BMIPP SPECT in the evaluation of CS patients.

Recent Findings

[18F]FDG PET is the gold standard to identify myocardial inflammation. [123I]BMIPP SPECT can uncover early myocardial damage as well as advanced stages of CS when fibrosis prevails. In presence of inflammation, myocardial [18F]FDG uptake is increased, but in contrast, BMIPP myocardial uptake is reduced or even suppressed. Thus, a complementary role of cardiac metabolic imaging by [18F]FDG PET and BMIPP SPECT has been proposed to detect the whole spectrum of CS.

Summary

[18F]FDG PET is considered an important tool to improve the diagnosis and optimize the management of CS. The role of [123I]BMIPP SPECT in diagnosing CS is still under investigation. Further studies are needed to evaluate the clinical utility of combined cardiac metabolic imaging in the diagnosis, prognosis, and for selecting treatments in CS patients.

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Acknowledgements

The authors are thankful to Daniel Cirigliano for the artwork and to Dr. Claudia Cortés for the thoughtful comments that strengthened this manuscript.

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  1. Departments of Nuclear Medicine and Cardiovascular Imaging, Diagnóstico Maipú-DASA, Av. Maipú 1668, Vicente López (B1602ABQ), Buenos Aires, Argentina

    Roxana Campisi, María Fernanda Merani & Marina I. Rodríguez

  2. Department of Nuclear Medicine, Instituto Argentino de Diagnóstico y Tratamiento S.A, Buenos Aires, Argentina

    Roxana Campisi & María Fernanda Merani

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Campisi, R., Merani, M.F. & Rodríguez, M.I. Assessment of Cardiac Sarcoidosis: FDG PET and BMIPP SPECT. Curr Cardiol Rep 24, 1873–1882 (2022). https://doi.org/10.1007/s11886-022-01803-4

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