FOCUS ISSUE ON CARDIAC SARCOIDOSIS Role of PET/ CT for the Identification of Cardiac Sarcoid Disease

Sarcoidosis reflects a multisystem granulomatous disease of unknown etiology that is characterized by the formation of non-caseating granuloma in various organs. Cardiac involvement may occur in one out of four patients accounting for an increased mortality rate in these patients. F-fluorodeoxyglucose-positron emission tomography( F-FDG-PET)is increasingly applied for the detection and characterization of systemic and cardiac sarcoid disease. In particular, F-FDG-PET has the unique potential to identify early and inflammatory cardiac sarcoid disease before developing structural alterations in the myocardium such as fibrosis and/or scarring. F-FDG-PET is not only suitable for early disease identification but also for installing and guiding immune-suppressive therapy to improve cardiovascular outcome that, however, needs to be further tested in large-scale clinical trials. FFDG-PET, is likely to introduce an image-guided and personalized preventive medicine approach in sarcoid patients in the near future.