Fig. 3

Examples of different FDG PET/CT and CMR patterns. In every image, baseline FDG PET/CT and CMR are shown on the left and repeated imaging on the right. A 48-year-old male patient who showed LGE uptake infero-lateral at first CMR (white arrows, short-axis view) without cardiac FDG-uptake (CMR+/PET−). The LGE increased at 2nd CMR with also increased T2-weighted signal (not shown); however, still no cardiac FDG-uptake was seen (CMR+/PET−), while the patient did not receive any immunosuppressive treatment. He was reclassified as probable CS. B A 36-year-old female patient who showed focal FDG-uptake infero-septal (white arrows) without LGE on CMR at baseline (CMR−/PET+). Between first and 2nd MDT, she was started on methotrexate 15 mg/week due to pulmonary sarcoidosis. Repeated imaging showed complete remission of cardiac FDG-uptake; however, CMR showed new LGE infero-septal (short-axis view, white arrows) and she was classified as CMR+/PET−. This patient was diagnosed with probable CS. C A 56-year-old male with focal FDG-uptake in the antero-lateral wall (white arrow, SUVmax 4.3) at baseline. He showed no LGE uptake on CMR (4 chamber view) and was classified as CMR−/PET+. The FDG-uptake was suspected to be physiologic and repeated imaging showed no cardiac FDG-uptake or LGE on CMR (CMR−/PET−). This patient received no immunosuppressive treatment between both MDT’s and CS was deemed “unlikely”. D A 47-year-old male patient who showed initial LGE inferoseptal on CMR (white arrow, short-axis view). However, after repeated imaging this LGE was interpreted as inferior hinge point fibrosis and not suspect for CS. Both FDG PET/CTs showed diffuse cardiac FDG-uptake (CMR+/PET+, CMR−/PET+). This patient did not receive any immunosuppressive therapies and was reclassified as “unlikely” CS