Systemic and inflammatory disorders involving the heart: the role of PET imaging.

Cardiac inflammatory disorders, either primarily cardiac or secondary to a systemic process, are associated with significant morbidity and/or mortality. Their diagnosis can be challenging, especially due to significant overlap in their clinical presentation with other cardiac diseases. Recent publications have investigated the potential diagnostic role of positron emission tomography (PET) imaging in these patients. Most of the available literature is focused on Fluorine-18 fluorodeoxyglucose (FDG), a tracer which has already demonstrated its use in other inflammatory and infectious processes. PET imaging can help in the diagnosis, prognosis and follow-up in a variety of cardiac inflammatory processes, including infective endocarditis, cardiac implantable electronic device infection, pericarditis, myocarditis, sarcoidosis and amyloidosis. PET's ability to depict metabolic changes and abnormalities, sometime even before the onset of any anatomical changes, can be a significant advantage over standard anatomical imaging. PET appears to be particularly useful in cases where standard investigation is non-diagnostic or equivocal.