What is Sarcoidosis? Sarcoidosis is an inflammatory disease which primarily affects the pulmonary system but has the potential of affecting multiple organs systems (multi-systemic) in the body and characterized by the...
What is Sarcoidosis?
Sarcoidosis is an inflammatory disease which primarily affects the pulmonary system but has the potential of affecting multiple organs systems (multi-systemic) in the body and characterized by the development of non-caseating granulomas.
The complications in lungs can range from less severe hilar adenopathy to interstitial lung disease and pulmonary hypertension, which are more severe.
What Causes Sarcoidosis?
The etiology of Sarcoidosis is unknown. A number of environmental and genetic factors play a role in development of Sarcoidosis, though pin-pointing towards any particular gene or environmental factor is difficult at the moment.
What All Organs Are Affected by Sarcoidosis?
Sarcoidosis causes inflammation and non-caseating granulomas, primarily in lungs but it can spread to other organ systems as well, such as:
- Cardiac
- Skin
- Lymph nodes
- Eyes
- Liver
Parts of the body that are rarely or less commonly affected by Sarcoidosis are:
What is Cardiac Sarcoidosis?
Cardiac Sarcoidosis – Majority of patients with Sarcoidosis show cardiac involvement. Cardiac Sarcoidosis is seen in up to 70% patients with Sarcoidosis.
Cardiac Sarcoidosis can be present without any clinical symptoms.
The involvement of heart in Sarcoidosis is patchy and not uniform.
Cardiac Sarcoidosis can result in the following complications:
- Atrioventricular block
- Conduction abnormalities
- Ventricular Arrhythmias
- Heart failure
- Cardiomyopathy
- Sudden cardiac death
- Valvular disease
Why Is Cardiac Sarcoidosis Detection Important?
Cardiac Sarcoidosis poses serious threats to health, as mentioned above. Hence, early detection and timely prognosis is very crucial to reduce morbidity and mortality because of Cardiac Sarcoidosis.
How Is Cardiac Sarcoidosis Diagnosed?
Since the cardiac involvement in Sarcoidosis is patchy, biopsies are not useful as parts of heart can appear normal in a biopsy.
Cardiac Sarcoidosis is diagnosed by using a combination of the following:
- Symptoms
- Imaging (Echocardiogram and PET scan)
- Electric rhythm of heart
How Does Pet Scan Work?
The principle behind detection of Cardiac Sarcoidosis in body by using PET scan is detection of radioactivity emitted by the radio tracer injected in the body. The radioactivity is detected as it emits photons.
Radiotracer is glucose which is radio – labeled (FDG - fluorodeoxyglucose) and it is injected into the body 1-2 hours before the actual scanning and imaging part of PET scan takes place.
18 F-FDG is readily taken up by macrophages in the tissues or areas of inflammation in the body.
Hence, areas of active inflammation are visible in a PET scan.
Is Pet Scan Effective in Diagnosing Cardiac Sarcoidosis?
PET scan along with other imaging techniques is better at diagnosing Cardiac Sarcoidosis as compared to traditional approaches, which were invasive and less effective, such as biopsy.
What are the sensitivity and specificity of FDG-PET scan in diagnosis of Cardiac Sarcoidosis?
Sensitivity of PET scan for Cardiac Sarcoidosis – 89%
Specificity of PET scan for Cardiac Sarcoidosis – 78%
How Is Difference in Color Interpreted During a Fdg-Pet Scan?
The color intensity and difference in colors that appear during PET scan signify different levels of metabolic activity of tissues.
Blue-green colors show moderate to low metabolic activity, yellow-orange colors indicate high metabolic activity and red indicates very high and alarming metabolic activity.
Following table can be referred for PET scan color coding:
|
Color |
Inference of metabolic activity |
|
Red |
Area of very high uptake of FDG |
|
Yellow |
Area of high uptake of FDG |
|
Green |
Area of moderate uptake of FDG |
|
Blue |
Area of low uptake of FDG |
|
Grey/Black |
Area of no uptake of FDG |
How Is Pet Scan Useful in Cardiac Sarcoidosis?
Diagnosis – Whole body scan can help in identification of regions of inflammation. Cardiac PET scan can identify active inflammation and granulomas in heart.
Prognosis – evaluation of Cardiac Sarcoidosis using PET scan helps in determination of personalized treatment strategy.
Treatment assessment – effectiveness of immunosuppressive therapy using corticosteroid is evaluated using PET scan for treating Cardiac Sarcoidosis.
Why Is Fasting Required Before Pet Scan?
Under normal conditions, myocardial cells take up glucose for energy.
During fasting state, the cells shift to lipid as the preferred energy substrate. In fasting state, there is uptake of 18 F-FDG only due to the inflammation caused by Cardiac Sarcoidosis.
Therefore, fasting is required to improve the specificity of PET scan by reducing physiological uptake of FDG by myocytes.
Why Can’t You Eat Carbohydrates Before Pet Scan?
You are advised to take a rich in fat and low carbohydrate diet before PET scan as this also helps in reducing physiological uptake of FDG by myocytes.
Cells (myocytes) shift from glucose to fatty acid metabolism.
Where to get PET Scan Done?
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Ganesh Diagnostic and Imaging Centre is known for providing excellent service and care to its patients for decades.
It is an established and renowned diagnostic centre since 2001.
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NABH accreditation is proof of highest standard of care and service provided to the patients. NABL accreditation reflects the competency of laboratories and equipment based on some national and international standards.
The facility for Pathology testing operates 24x7, 365 days, providing service to patients round the clock!
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The rates of tests are reasonably priced. Ganesh Diagnostic and Imaging Centre also offer FLAT 50% OFF on many tests.
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