Table 3.

Imaging modalities recommended at the time of diagnosis and during follow-up.

Imaging modality	At diagnosis	Follow-up
Echocardiography	• Main imaging modality to diagnose left ventricular dilatation and systolic dysfunction • Clues for diagnosis of etiology • Prognostication (left/right ventricular function; degree of mitral regurgitation, presence of diastolic impairment)	• Prognostication (left/right ventricular systolic function improvement, mitral regurgitation improvement: left ventricular restrictive filling pattern improvement)	Main imaging technique during follow up—should be repeated at regular intervals
CMR	• Accurate assessment of volumes and systolic function • Differential diagnosis • Identification of cause • Prognostic stratification, including risk of sudden cardiac death (right ventricular involvement, late gadolinium enhancement)	• Increasingly used for prognostication	Role of CMR during follow-up needs to be further assessed
CT coronary angiogram	• Identification of cause (exclusion of ischemic heart disease—to be used in patients with low pre-test probability for coronary artery disease)	Not used
PET/SPECT	• Tissue characterization—can aid in the diagnosis of the cause of left ventricular dysfunction (for example, sarcoidosis or cardiac amyloidosis), which has implications on treatment and prognostication	In the case of sarcoidosis, 18F-FDG PET is used to monitor the response to steroids

CMR, cardiac magnetic resonance; CT, computed tomography; PET, positron emission tomography; SPECT, single photon emission computed tomography; 18F-FDG, 18F-fluorodeoxyglucose.