Evaluation of the Prognostic Value of PET/MRI in Cardiac Sarcoidosis (SARCASTIM)
Prospective Comparative Multicenter Study Evaluating the Prognostic Interest of PET/MRI in Cardiac Sarcoidosis
Cardiac damage is the second leading cause of death in patients with sarcoidosis, after lung damage. Today's challenge is to diagnose the disease as effectively as possible, and to develop tools for better risk stratification, especially for sudden death, in order to better target therapies and implantable devices, such as corticoids and immunosuppressant.
The hypothesis is that combined PET (Positron Emission Tomography)/MRI (Magnetic Resonance Imaging) could be a relevant prognostic marker of progression, and would significantly improve diagnostic performance in patients with suspected cardiac sarcoidosis (CS). This study will also make it possible to distinguish sequellar fibrosis lesions from granulomatous lesions and assess the therapeutic response. Incorporating PET/MRI into the diagnostic strategy for patients with suspected CS could therefore improve their management.
Study Overview
Status
Status
Conditions
Conditions
Intervention / Treatment
Intervention / Treatment
Study Type
Study Type
Enrollment (Estimated)
Enrollment
Phase
Phase
- Not Applicable
Contacts and Locations
Study Contact
Study Contact
- Name: Vania TACHER, PHD
- Phone Number: 01 49 81 29 29
- Email: vania.tacher@aphp.fr
Study Contact Backup
- Name: Samia BALOUL
- Phone Number: 01 49 81 33 85
- Email: samia.baloul@aphp.fr
Study Locations
-
-
-
Créteil, France
- Recruiting
- Henri Mondor Hospital
-
-
Participation Criteria
Eligibility Criteria
Eligibility Criteria
Ages Eligible for Study
- Adult
- Older Adult
Accepts Healthy Volunteers
Description
Inclusion Criteria:
- Age ≥ 18 years
- Sarcoidosis defined according to ATS/ERS/WASOG criteria
Suspicion of cardiac involvement in sarcoidosis:
- Clinical manifestations (syncope, lipothymia, persistent palpitations, signs of heart failure) and/or
- Cardiac rhythm or conduction disorder (Mobitz type 2 atrioventricular block (AVB), AVB 3, right or left bundle branch block, Q wave in at least 2 leads, ventricular arrhythmia (ventricular mono/polymorphic complexes> 1000 per 24 h, ventricular tachycardia, ventricular fibrillation), unexplained sustained VT or epsilon wave) and/or
- Compatible cardiac ultrasound abnormality: left ventricular dilatation, septal thickening or wall thinning (especially basal), segmental kinetic disorder and wall aneurysm without coronary anomaly, altered left ventricular ejection fraction, altered diastolic function, altered right ventricular systolic function.
- Informed patient consent
- Membership of a social security scheme
Exclusion Criteria:
- Psychiatric illness not controlled by treatment
- Claustrophobia
- Known pregnancy or breast-feeding patient
- Unbalanced diabetes (influence on carbohydrate metabolism for PET)
- Previous infarction or known coronary disease
- Known allergy to gadolinium and fluoro-desoxyglucose and their excipients
- Renal insufficiency (Clairance < 30 mL/min/1.73m2)
- Implanted pacemaker not compatible with a 3 Teslas magnetic field
- Patients with ocular metallic foreign bodies, pacemakers, neurostimulators, cochlear implants, metallic heart valves, vascular clips formerly implanted on cranial aneurysms and, in general, any non-removably implanted electronic medical equipment
- Inability or refusal to follow a low-carbohydrate diet for 24 hours, followed by a 6-hour fast required prior to the examination
- Patient unable to hold a 10-second apnea.
- Patient deprived of liberty by judicial or administrative decision
- Patient under legal protection (guardianship, curatorship)
- Participation in other interventional research involving the human person or being in the exclusion period following previous research involving the human person
- Patients under AME
Exclusion criteria (post signature of consent) for women of reproductive age :
- Positive pregnancy test result after inclusion
Study Plan
How is the study designed?
Design Details
- Primary Purpose: Diagnostic
- Allocation: N/A
- Interventional Model: Single Group Assignment
- Masking: None (Open Label)
Number of Arms
Arms and Interventions
Participant Group / ArmParticipant Group / Arm |
Intervention / TreatmentIntervention / Treatment |
|---|---|
|
Other: Prospective cohort of patients
Patients with suspected cardiac sarcoidosis
|
PET/MRI is a new-generation hybrid camera capable of simultaneously performing FDG positron emission tomography and gadolinium-injected MRI.
PET/MRI could be a relevant prognostic marker of progression, and could significantly improve diagnostic performance in patients with suspected cardiac sarcoidosis.
|
What is the study measuring?
Primary Outcome Measures
Primary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Occurrence of a severe cardiological event
Time Frame: Up to 24 months
|
Occurrence during follow-up of at least one of the severe cardiological events listed below attributed to sarcoidosis, assessed at 24 months:
|
Up to 24 months
|
Secondary Outcome Measures
Secondary Outcome Measures
Outcome Measure |
Measure Description |
Time Frame |
|---|---|---|
|
Frequency of severe cardiological events between patients with and without Delayde MRI enhancement
Time Frame: Up to 24 months.
|
Among patients with hypermetabolic FDG PET uptake
|
Up to 24 months.
|
|
Frequency of severe cardiological events according to each modality of PET/MRI results in terms of Delayde MRI enhancement and hypermetabolic fixation on PET.
Time Frame: Up to month 24.
|
MRI- PET-; MRI- PET+; MRI+ PET-; and MRI+ PET+.
|
Up to month 24.
|
|
Percentage of patients initially well classified (diagnostic accuracy) in terms of probability of cardiac involvement
Time Frame: Up to month 24.
|
Percentage of patients initially well classified (diagnostic accuracy) in terms of probability of cardiac involvement (absent, possible, probable or very probable) by each examination (MRI alone, PET alone, or PET/MRI) in relation to the diagnosis established at two years (reference).
|
Up to month 24.
|
|
Comparison of FDG PET metabolic activity and late gadolinium enhancement of pathological areas before and after treatment.
Time Frame: Up to month 3 and 12.
|
For patients with initial pathological MRI-PET.
|
Up to month 3 and 12.
|
Collaborators and Investigators
Sponsor
Sponsor
Investigators
Investigators
- Study Director: Matthieu MAHEVAS, PHD, Assistance public Hôpitaux de Paris
Study record dates
Study Major Dates
Study Start (Actual)
Study Start
Primary Completion (Estimated)
Primary Completion
Study Completion (Estimated)
Study Completion
Study Registration Dates
First Submitted
First Submitted
First Submitted That Met QC Criteria
First Submitted That Met QC Criteria
First Posted (Actual)
First Posted
Study Record Updates
Last Update Posted (Actual)
Last Update Posted
Last Update Submitted That Met QC Criteria
Last Update Submitted That Met QC Criteria
Last Verified
Last Verified
More Information
Terms related to this study
Keywords
Additional Relevant MeSH Terms
Other Study ID Numbers
Other Study ID Numbers
- APHP191100
Plan for Individual participant data (IPD)
Plan to Share Individual Participant Data (IPD)?
IPD Plan Description
Drug and device information, study documents
Studies a U.S. FDA-regulated drug product
Studies a U.S. FDA-regulated device product
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