Qualitative and Quantitative Assessments of Cardiac Sarcoidosis Using ¹⁸F-FDG PET

Abstract

Sarcoidosis is a multisystem disease pathologically characterized by non-caseating granuloma. Cardiac sarcoidosis (CS) remains an important prognostic factor of sarcoidosis patients. ¹⁸F-fluorodeoxyglucose (¹⁸F-FDG) positron emission tomography (PET) has been applied as a noninvasive tool not only for CS diagnoses but also for the evaluation of therapeutic effects and prognoses. Visual assessment is a standard method to evaluate whether the ¹⁸F-FDG uptake is physiological or active inflammation due to the CS. A semi-quantitative assessment using the standardized uptake value (SUV) is a simple method for achieving a more accurate diagnosis. A volume-based analysis has been proposed as a new marker that can provide information about the improvement or prevention of heart failure and can be used to predict a further clinical event in CS patients. This is a brief review of the objective and quantitative assessments of the magnitude and extent of CS activity with the use of ¹⁸F-FDG PET.