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SINAPSE Image of the Month: Cardiac MR-PET

July 2017 SINAPSE Image of the Month

Courtesy of Dr Marc Dweck, this image demonstrates the diagnostic usefulness of MR-PET imaging for active cardiac sarcoidosis. The left column shows gadolinium-enhanced cardiac MR images, and the right column shows hybrid 18F-fluorodeoxyglucose (FDG) cardiac MR-PET images, from four patients with clinical suspicion of active cardiac sarcoidosis. Gadolinium-enhanced MR allows visualization of myocardial injury, but cannot differentiate between active disease and chronic scarring, whereas active sarcoidosis is indicated by focal increases in myocardial FDG uptake. A single MR-PET scan enables detection of increased FDG activity (through the PET modality) co-localized precisely with the pattern of myocardial injury (through the MR modality) – as in these instances – improving the diagnostic accuracy of active cardiac sarcoidosis.

The image is taken from a recent study published in JACC: Cardiovascular Imaging:

Dweck MR, Abgral R, Trivieri MG, Robson PM, Karakatsanis N, Mani V, Palmisano A, Miller MA, Lala A, Chang HL, Sanz J, Contreras J, Narula J, Fuster V, Padilla M, Fayad ZA, Kovacic JC. Hybrid Magnetic Resonance Imaging and Positron Emission Tomography With Fluorodeoxyglucose to Diagnose Active Cardiac Sarcoidosis. JACC: Cardiovascular Imaging, Available online 14 June 2017.