Assessment of Cardiac Sarcoidosis with Advanced Imaging Modalities
Figure 6
Diagnostic algorithm for a patient with suspected for cardiac involvement in extra-cardiac sarcoidosis. ā Absence of coronary artery disease as determined by selective coronary angiography and the absence of a comorbidity that could explain heart failure. Patients with initially negative screening tests should have repeat evaluations at follow-up visits. Cardiac MRI is the most specific test and 18F-FDG PET is the most sensitive test available for cardiac sarcoidosis. 18F-FDG PET should be considered for patients with positive findings on cardiac MRI to assess inflammatory activity before initiating corticosteroid therapy. 18F-FDG PET-guided myocardial biopsy should be performed in patients with a contraindication to cardiac MRI.