Updates in fluorodeoxyglucose positron emission tomography (18FDG-PET) in the diagnosis and management of cardiac sarcoidosis.

Cardiac sarcoidosis (CS) is an infiltrative cardiomyopathy characterized by non-caseating granulomatous inflammation that results in significant morbidity and mortality. It has become increasingly recognized over the past several decades; however, diagnosis remains challenging due to its heterogeneous nature and limited diagnostic yield of endomyocardial biopsy. As such, there has been increasing reliance on advanced cardiac imaging to aid in the diagnosis and management of CS. Fluorodeoxyglucose positron emission tomography (18FDG-PET) has emerged as the most robust imaging modality and remains the preferred method for assessing active inflammation, treatment response, and surveillance. Nevertheless, it requires meticulous patient preparation and image acquisition to ensure optimal imaging and interpretation. This article aims to provide a comprehensive review of the various imaging modalities used for the diagnosis of CS, with a particular focus on the intricacies of 18FDG-PET, including the latest advancements in patient preparation and study interpretation. Other future directions for the diagnosis and management of CS will also be discussed.