SCMR/SISIAC Joint Webinar: Sarcoidosis, Clinical Image-SCMR/SISIAC Joint Webinar: Sarcoidosis, Clinical Image

Video Transcription

Video Summary

This bilingual webinar, jointly hosted by CICIAC and the Society of Cardiovascular Magnetic Resonance, focused on cardiac sarcoidosis and its imaging diagnosis, featuring experts Dr. Mario García and Dr. Amit Patel. The speakers highlighted the value of multimodality imaging—especially cardiac MRI and FDG-PET—in identifying active inflammation, scar, extracardiac disease, and biopsy targets.<br /><br />Two cases illustrated the challenges of diagnosis. The first was a woman with complete heart block, normal echocardiogram, but MRI showing septal and inferoseptal late gadolinium enhancement, followed by PET evidence of active myocardial inflammation and mediastinal lymphadenopathy. Biopsy of an accessible lymph node confirmed non-necrotizing granulomas consistent with sarcoidosis. The panel emphasized that early imaging can guide treatment and device choice, including whether a pacemaker alone or an ICD is needed.<br /><br />The second case involved a young woman initially diagnosed with cardiac sarcoid based on MRI and PET, but later found on transplant pathology to have arrhythmogenic cardiomyopathy with fibro-fatty infiltration, showing how sarcoidosis can be mimicked by genetic cardiomyopathies. The discussion stressed the importance of broad differential diagnosis, careful review of extracardiac findings, and genetic testing when the diagnosis is uncertain.<br /><br />The panel also reviewed key concepts: patchy myocardial involvement, septal predilection, limitations of endomyocardial biopsy, PET diet preparation, and the role of imaging in monitoring treatment response. Questions from attendees covered SPECT vs PET, MRI follow-up, genetic testing, and the overlap with Chagas disease. The session concluded by promoting the upcoming SCMR meeting in Rio de Janeiro.

Keywords

cardiac sarcoidosis

multimodality imaging

cardiac MRI

FDG-PET

late gadolinium enhancement

myocardial inflammation

mediastinal lymphadenopathy

non-necrotizing granulomas

arrhythmogenic cardiomyopathy

genetic testing

endomyocardial biopsy