Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology Image fusion between 18F-FDG-PET and MRI in cardiac sarcoidosis: A case series Shahin ZANDIEH, Reinhard BERNT, Siroos MIRZAEI, Joerg HALLER, Klaus HERGAN 1Institute of Radiology and Nuclear Medicine, Hanusch Hospital, Teaching Hospital of Medical University of Vienna, Austria 2Department of Nuclear Medicine with PET-center, Wilhelminenspital, Vienna, Austria 3Department of Radiology, Paracelsus Medical University of Salzburg, Austria Head shot of author required Institution Picture/Logo Optional Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology BACKGROUND Sarcoidosis is a chronic systemic disease of unknown etiology. It is characterized by the presence of noncaseating epithelioid granulomas. This study demonstrates the use of image fusion between (18)F-fluoro-2-deoxy-D-glucose positron emission tomography (18F-FDG-PET) and magnetic resonance imaging (MRI) to diagnose patients with cardiac sarcoidosis (CS). Copyright American Society of Nuclear Cardiology

METHODS Study type: Retrospective Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology METHODS Study type: Retrospective B. Study subjects: Seven patients diagnosed with cardiac sarcoidosis were retrospectively included. All patients underwent 18F-FDG PET/CT and cardiac MRI. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS On the MRI, LGE was observed in the lateral wall in two patients, confirming myocardial infiltration. In three patients, we found LGE in the septal wall segments. In two patients, LGE was recognized in the apical segment. One patient additionally showed pericardial LGE. T2-weighted images revealed areas with increased signal intensity consistent with myocardial edema in two patients and with hypointensity suggesting fibrosis in the lateral wall in one patient. On the cine sequence, hypokinesia was observed in four patients and dyskinesia in one patient without active inflammation. Increased and inhomogeneous 18F-FDG PET uptake was seen in the septal wall in three patients and in the lateral wall in one patient. The additive value in cases of 18F-FDG uptake in the myocardial wall was suggesting of active inflammation in line with CS and leading to diagnosis of CS. Copyright American Society of Nuclear Cardiology

RESULTS Insert a key table or a key figure If figure, insert legend Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology RESULTS Insert a key table or a key figure If figure, insert legend An increased 18F-FDG uptake was found in the septal heart wall in PET/MRI images (white arrows). Based on the imaging findings, sarcoidosis with cardiac involvement was diagnosed. Enhanced 18F-FDG uptake the septal wall in PET/MRI images (white arrows). Based on the imaging findings, sarcoidosis with cardiac involvement was diagnosed. Copyright American Society of Nuclear Cardiology

Journal of Nuclear Cardiology | Official Journal of the American Society of Nuclear Cardiology CONCLUSIONS 18F-FDG-PET and cardiac MRI image fusion allows clinicians to obtain complete morphofunctional cartography in patients with CS. Our data show that 18F-FDG PET/MRI fusion imaging can be useful in the diagnosis of CS. Copyright American Society of Nuclear Cardiology