Assessment of Cardiac Sarcoidosis with Advanced Imaging Modalities

Figure 7

Diagnostic algorithm for a patient with suspected for cardiac sarcoidosis. ^★Absence of coronary artery disease as determined by selective coronary angiography and the absence of a comorbidity that could explain heart failure. Cardiac MRI is the most specific test and ¹⁸F-FDG PET is the most sensitive test available for cardiac sarcoidosis. In patients without a prior history of sarcoidosis, cardiac MRI should be considered if they have type II 2nd degree or complete atrioventricular block, sustained ventricular tachycardia, or unexplained systolic or diastolic LV dysfunction. ¹⁸F-FDG PET should be performed in patients with positive findings on cardiac MRI or contraindication to cardiac MRI to detect both cardiac and extra-cardiac sarcoid lesions, and ¹⁸F-FDG PET-guided biopsy should be performed.