FDG PET for cardiac sarcoidosis: Protocol optimization, quantification, pitfalls, and multimodality imaging integration.

Cardiac sarcoidosis (CS) is a clinically heterogeneous disorder associated with significant morbidity and mortality, including heart failure, conduction abnormalities, ventricular arrhythmias, and sudden cardiac death. Contemporary diagnostic strategies rely on a probabilistic multimodality imaging framework including echocardiography, cardiac magnetic resonance imaging, and positron emission tomography (PET). This review summarizes the integration of multimodal imaging findings and highlights the role of PET imaging in the diagnosis and management of CS with particular emphasis on recent advancements in the field of nuclear cardiology with respect to CS including extended dietary preparation protocols, serum beta-hydroxybutyrate monitoring, quantitative analysis of PET, use of serial PET imaging, applications of artificial intelligence, and emerging PET traces that are increasingly influencing real-world clinical practice.