Multimodality Imaging in the Contemporary Work-Up of Cardiac Sarcoidosis

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Abstract Purpose of Review This review critically evaluates the most recent literature on the role of various imaging modalities, including echocardiography, computed tomography (CT), cardiac magnetic resonance imaging (CMR), single-photon emission tomography (SPECT) and fluorodeoxyglucose positron emission tomography (FDG-PET) in cardiac sarcoidosis (CS) detection and management. The review also discusses emerging advancements, such as artificial intelligence (AI) integration and hybrid imaging techniques. Recent Findings CS is a challenging disease to diagnose due to its heterogeneous presentation and often subtle cardiac involvement. Multimodality imaging plays a crucial role in the contemporary work-up of CS, allowing for more accurate diagnosis, risk stratification, and treatment monitoring. Summary Current imaging techniques, including echocardiography, CMR, SPECT, FDG-PET and hybrid modalities such as PET/CT and PET/MR offer complementary information on myocardial inflammation, fibrosis, and functional impairment, thereby enhancing diagnostic confidence and guiding management decisions. Additionally, emerging applications of artificial intelligence and machine learning are showing promise in automating image interpretation, improving diagnostic precision, and supporting personalized risk stratification. The integration of advanced imaging with AI-driven tools represents a future direction for optimizing clinical outcomes in patients with cardiac sarcoidosis.

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