Journal article
Global Practices in Cardiac Imaging for Cardiac Sarcoidosis: A Survey Study of International Experts With Delphi Consensus
JACC. Cardiovascular imaging, Vol.18(6), pp.679-692
06/01/2025
DOI: 10.1016/j.jcmg.2025.02.010
PMID: 40467149
Abstract
Background: Cardiac imaging is a cornerstone in the initial diagnosis, management, and follow-up of cardiac sarcoidosis. However, ordering thresholds, access, and follow-up imaging vary across the globe. Objectives: A Delphi study was conducted to define areas of consensus and areas requiring further study in the use of cardiac imaging in suspected or established cardiac sarcoidosis. Methods: An international, multidisciplinary panel of experts in cardiac sarcoidosis completed a modified 2-round Delphi study. The study evaluated clinical decision making regarding the use of cardiac imaging, including indication thresholds, interpretation, and interval follow-up imaging. Consensus was defined a priori as ≥70% agreement or disagreement. Results: A total of 89 experts in cardiac sarcoidosis (89 in round 1 and 75 in round 2) participated, representing 61 centers in 13 countries. Consensus was reached on 22 of 46 items (48%) in round 1 and 21 of 29 items (72%) in round 2. There was a low threshold to order advanced cardiac imaging for new rhythm abnormalities or ventricular dysfunction detected on echocardiography in patients with established extracardiac sarcoidosis.
F-fluorodeoxyglucose (FDG) positron emission tomography was an important co-primary modality with cardiac magnetic resonance (CMR) for initial diagnosis. If CMR was the first test, there was consensus to proceed to FDG–positron emission tomography after any abnormal CMR result or even after normal CMR result in the setting of moderate or high pretest probability for cardiac sarcoidosis. There was consensus that late gadolinium enhancement quantification was important, but there was no consensus on the threshold of risk or on how best to quantify late gadolinium enhancement. Similarly, reduction in FDG uptake was an important factor in guiding treatment response, but there was no consensus on how to best quantify FDG uptake or what constituted an adequate radiographic response. Conclusions: Several consensus areas for cardiac imaging in suspected and established cardiac sarcoidosis were identified. This consensus study identified areas of priority for future prospective, controlled, multicenter research studies.
Details
- Title: Subtitle
- Global Practices in Cardiac Imaging for Cardiac Sarcoidosis: A Survey Study of International Experts With Delphi Consensus
- Creators
- Tahir S. Kafil - Mayo ClinicManuel L. Ribeiro Neto - Cleveland ClinicMarc A. Judson - Albany Medical CollegeLeslie T. Cooper - Mayo ClinicJordana Kron - Virginia Commonwealth University Medical CenterJan C. Grutters - University Medical Center UtrechtDavid H. Birnie - Ottawa Heart InstituteRonald Witteles - Stanford University School of MedicineEmer Joyce - Mater Misericordiae University HospitalEdward J. Miller - Yale UniversityAmit S. Patel - King's College HospitalDaniel A. Culver - Cleveland ClinicChristine L. Jellis - Cleveland ClinicCardiac Sarcoidosis Expert PanelistsNabeel HamzehKory LavineFabio ArimuraArthur YeeNisha A. GilotraW. H.Wilson TangMatthew C. BakerGerard GiblinLeila LaroussiChetan ShenoyRob BeanlandsAmanda VestDavid PriorCalambur NarasimhanFrancis MurgatroydWim WuytsWael JaberDivya PatelDaniel SadoD. Ian PatersonAamer SyedSanjay DivakaranVasilis KouranosTerrence RuddyA. M.D.Renske VorselaarsRobert P. BaughmanToshiyuki NagaiMareye VoortmanRon BlanksteinIndu PoornimaCori E. RussellMario SenechalThomas PlanteMartin SwaansTom CallahanPaul KimGirish DwivediLisa MaierToshiyuki YanoDebabrata BandyopadhyayJames GallowayJonathan ChrispinKenji YodogawaJan M. GriffinYogita RochlaniLine KemeyouElliott CrouserW. Ennis JamesKosuke NakasukaBettina HeideckerRoger AllenLaura MurphyMustafa TomaMarcel VeltkampAmanda VarnavaFatima AkdimGenevieve GiraldeauFelix Ayala-ParadesRichard K. ChengEdward S. ChenPaul CremerNikolaos TzemosMarloes HuitemaPaolo SpagnoloManuel RibeiroKengo KusanoKelly ArpsFarooq H. SheikhMatthias FriedrichVanessa FerreiraMarco PostJukka LehtonenPatompong UngprasertJoanna PorterAthol WellsZiad Taimeh
- Resource Type
- Journal article
- Publication Details
- JACC. Cardiovascular imaging, Vol.18(6), pp.679-692
- DOI
- 10.1016/j.jcmg.2025.02.010
- PMID
- 40467149
- NLM abbreviation
- JACC Cardiovasc Imaging
- ISSN
- 1936-878X
- eISSN
- 1876-7591
- Publisher
- ELSEVIER SCIENCE INC
- Grant note
- MallinckrodtKinevantXentriaATyr PharmaPfizerGEAlnylamEidosSiemens
Dr Judson has served as a consultant for Biogen; his institution has received research grants from Mallinckrodt, Kinevant, Xentria, and aTyr Pharma. Dr Cooper has served as a consultant for Bristol Meyers Squibb, CardiolRx, Kiniksa, and Moderna; and has equity ownership in Stromal Therapeutics. Dr Witteles has served as a consultant for Pfizer, Alnylam, AstraZeneca, Alex ion, Novo Nordisk, and BridgeBio. Dr Miller has served as a consultant for GE and CSL Behring and has received grant support from Pfizer, GE, Alnylam, Eidos, and Siemens. Dr Culver has served as a consultant for Foresee Pharmaceuticals and Boehringer Ingelheim. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Language
- English
- Date published
- 06/01/2025
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Internal Medicine
- Record Identifier
- 9984825524302771
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