142 Results Between October 2017 and February 2024, 1214 patients with suspected cardiac sarcoidosis were evaluated by the cardiac sarcoidosis MDT. Indications for MDT evaluation were mainly presence of symptoms suggesting cardiac sarcoidosis or incidental findings in the myocardium on FDG PET/CT made to evaluate extracardiac sarcoidosis. Of these 1214 patients, 59 (5%) also underwent [123I]MIBG scintigraphy, and 46 of them consented to the use of their data for this study. Demographic and clinical characteristics are summarized in Table 1. Among 46 symptomatic sarcoidosis patients who underwent [123I]MIBG scintigraphy, 20 (44%) demonstrated abnormalities indicative of SCAD. Of the 20 cases with abnormal [123I]MIBG scintigraphy, six were diagnosed with cardiac sarcoidosis. Of the 46 patients, 40 underwent both FDG PET/CT and CMR, while one of these imaging modalities was performed in the remaining six patients. Among the 40 patients who underwent both investigations, only one patient (3%) demonstrated evidence of cardiac sarcoidosis on both FDG PET/CT and CMR. This patient also showed abnormal findings on [123I]MIBG scintigraphy (see Table 1). No significant differences were found in demographic characteristics and FDG PET/CT outcome between patients with and without abnormal [123I]MIBG scintigraphy (see Table 1). Table 1 Summary demographic data and clinical data of patients with sarcoidosis who underwent an [123I]MIBG scintigraphy, subdivided in normal and abnormal [123I]-MIBG scintigraphy. Total group (n=46) [123I]MIBG normal (n=26) [123I]MIBG abnormal (n=20) Age, years, mean ± SD 48±11 44±9 52±12 Male, % (n) 54 (25) 50 (13) 60 (12) BMI kg/m2, mean ± SD 28±5 29±4 27±5 Time since diagnosis, years, median ± IQR 8±7 8±6 9±12 Cardiac sarcoidosis, %(n) 20 (9) 12 (3) 30 (6) FDG PET/CT cardiac involvement yes, %(n); missing, n 3 (1); 2 0 (0); 2 5 (1); 0 CMR abnormal, % (n); missing, n 3 (1); 4 0 (0); 3 5 (1); 1 Therapy % (n) No immunosuppressive therapy, % (n) 63 (29) 73 (19) 50 (10) Prednisone, % (n) 17 (8) 15 (4) 20 (4) Methotrexate, % (n) 17 (8) 12 (3) 25 (5) TNF-alpha inhibitors, infliximab or adalimumab, % (n) 4 (2) 4 (1) 5 (1) Methylprednisone, % (n) 2 (1) 4 (1) 0 (0) Adalimumab, % (n) 2 (1) 0 (0) 5 (1) n: number; SD: standard deviation; BMI: body mass index; IQR: interquartile range; SFN: small fiber neuropathy; FDG PET/CT: Fluordeoxyglucose positron emission tomography; CMR: cardiac magnetic resonance imaging; TNF: tumor necrosis factor. Comparing [123I]MIBG scintigraphy abnormal vs normal all p’s were > 0.05 (not significant). No differences were found in presenting symptoms between patients with an abnormal [123I]MIBG scan and patients who had a normal [123I]MIBG scan (Table 2). 9 148 9
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