PET/CT in Diagnosis and Treatment Monitoring of Cardiac Sarcoidosis: A Single-Center Experience

Cardiac sarcoidosis (CS) is an inflammatory heart disease with severe complications. Early and accurate diagnosis is crucial for optimal patient management. Positron emission tomography/computed tomography (PET/CT) has emerged as a pivotal imaging modality for detecting both active myocardial inflammation and/or scar, guiding therapeutic decisions, and monitoring treatment response in patients with CS. Material and Methods: We retrospectively analyzed PET/CT scans from 2014 to 2024 in patients with systemic sarcoidosis or suspected CS. Results: Among 103 patients, 12 were diagnosed with CS. FDG PET/CT revealed pathological uptake patterns in all patients, and 50% had right ventricular involvement. Myocardial perfusion PET/CT, performed in 5 patients, detected concomitant scar in 4 patients. After immunosuppressive therapy, 77.8% showed complete metabolic response. Despite generally favorable outcomes, 2 cardiac events were registered. Conclusions: Our findings highlight the essential role of PET/CT in the early diagnosis and ongoing management of CS. This imaging technique allows for the timely detection of myocardial inflammation, facilitates risk stratification, and enables clinicians to tailor immunosuppressive therapy based on individual response. Early and accurate identification of cardiac involvement through PET/CT can ultimately improve patient outcomes by allowing for prompt and appropriate treatment adjustments.