Role of multimodality imaging including Thallium-201 myocardial perfusion imaging in the diagnosis and monitoring of treatment response in cardiac sarcoidosis

Excerpt

Sarcoidosis is a multisystem granulomatous disorder of unknown etiology that can involve any organ in the body including the heart. The clinical manifestation of cardiac sarcoidosis is variable and includes asymptomatic state, conduction abnormalities, ventricular arrhythmias, heart failure and sudden death.1 Advanced imaging modalities like cardiac MRI and PET are increasingly being utilized in the work-up.2 PET is not widely available and MRI may not be an option in patients with pacemaker and/or implantable defibrillator (ICD). Myocardial perfusion imaging with Thallium-201 or Tc-99m Sestamibi remains an alternative approach especially to monitor therapy as illustrated in our patient. In institutions not equipped with PET CT, diagnosis of cardiac sarcoidosis can be made by following the revised guidelines of the Japanese society of granulomatous disorders, which are based on the clinical findings, myocardial perfusion imaging and cardiac MR, elaborated at the bottom of our discussion.3 …