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18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the interest of 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) for diagnosis and therapeutic follow-up of patients with sarcoidosis.

Methods

Twenty consecutive patients with biopsy-proven sarcoidosis were retrospectively included, in particular, 13 and seven cases of thoracic and extra-thoracic sarcoidosis, respectively. All patients underwent 18F-FDG PET/CT, and 12 of them also 67Ga scintigraphy. Five patients were re-examined by 18F-FDG PET/CT to assess response to corticosteroid (CS) treatment.

Results

Sensitivity of 18F-FDG PET/CT in detecting active sarcoidosis localizations was determined considering only biopsy-proven sites. For thoracic, sinonasal, and pharyngo-laryngeal localizations, 18F-FDG PET/CT sensitivity was 100%, 100%, and 80%, respectively. Overall sensitivity for all 36 biopsy-proven localizations improved from 78% to 87% after excluding skin involvement. Considering only the 12 patients who underwent both scintigraphic examinations, overall sensitivity of 67Ga scintigraphy and 18F-FDG PET/CT was 58% and 79%, respectively and improved to 67% and 86% after excluding all sites of skin involvement. To evaluate the efficacy of CS treatment, five enrolled patients underwent second 18F-FDG PET/CT. Complete regression of all foci of pathological tracer uptake was showed in two cases, permitting CS withdrawal after 2 and 6 months. Improvement but incomplete regression of mediastino-pulmonary disease occurred in two patients treated with CS for 19 and 21 months. Disease progression was assessed in one patient treated with decreasing doses of CS during 16 months.

Conclusion

18F-FDG PET/CT allows to obtain a complete morpho-functional cartography of inflammatory active localizations and to follow treatment efficacy in patients with sarcoidosis, particularly in atypical, complex, and multisystemic forms.

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Authors and Affiliations

  1. Service ORL, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France

    Jean Jacques Braun

  2. Service de Pneumologie Lyautey, Hôpital Civil, Hôpitaux Universitaires de Strasbourg, 67000, Strasbourg, France

    Jean Jacques Braun

  3. Service de Pneumologie, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 67098, Strasbourg, France

    Romain Kessler

  4. Service de Biophysique et de Médecine Nucléaire, Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, 1, Avenue Molière, 67098, Strasbourg Cedex, France

    André Constantinesco & Alessio Imperiale

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  1. Jean Jacques Braun
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  2. Romain Kessler
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  3. André Constantinesco
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  4. Alessio Imperiale
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Correspondence to Alessio Imperiale.

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Braun, J.J., Kessler, R., Constantinesco, A. et al. 18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging 35, 1537–1543 (2008). https://doi.org/10.1007/s00259-008-0770-9

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  • DOI: https://doi.org/10.1007/s00259-008-0770-9

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