Fig. 1

Cardiac magnetic resonance imaging with gadolinium and ¹⁸F-fluorodeoxyglucose-positron emission tomography at time of diagnosis and during follow-up. Advanced imaging for a Patient 1 shows i cardiac magnetic resonance imaging reported in the clinical setting as within normal limits. Re-review for the purposes of publication found the scan was of insufficient quality to accurately detect presence of delayed enhancement. ii ¹⁸F-fluorodeoxyglucose-positron emission tomography at time of presentation demonstrates abnormal heterogeneous and moderate-to-markedly increased metabolism in hilar and mediastinal nodes consistent with cardiac sarcoidosis, as well as cardiomegaly and diffuse uptake in both ventricles and the right atrium. iii Progress ¹⁸F-fluorodeoxyglucose-positron emission tomography following 3 months’ treatment with prednisone and methotrexate demonstrates response to treatment with a reduction in the size and metabolism of the hilar and mediastinal lymph nodes. In addition, the heart is smaller and the increased uptake seen in the right ventricle and the right atrium on the initial scan has resolved, although there is persistent metabolism in the septum. iv Progress ¹⁸F-fluorodeoxyglucose-positron emission tomography following 17 months of immunosuppression demonstrates response to treatment with complete resolution of abnormal metabolism in the myocardium, but persisting areas of avidity in the mediastinal and hilar lymph nodes. b Patient 2 shows i cardiac magnetic resonance imaging with no abnormalities detected at presentation. ii ¹⁸F-fluorodeoxyglucose-positron emission tomography at time of presentation demonstrates abnormal active sites of focal myocardial inflammation in the basal anteroseptum, basal septum, and inferior walls that was consistent with cardiac sarcoidosis. iii Progress ¹⁸F-fluorodeoxyglucose-positron emission tomography following 6 months of immunosuppression with prednisone and methotrexate demonstrates resolution of previously abnormal focal increased ¹⁸F-fluorodeoxyglucose accumulation in the left ventricle consistent with resolution of areas of inflammation