Current clinical use of 18FDG-PET/CT in patients with thoracic and systemic sarcoidosis

PurposeThis study assessed the role of whole-body 18fluorodeoxyglucose positron-emission tomography/computed tomography (18FDG PET/CT) in the restaging and follow-up of patients with sarcoidosis previously studied by multidetector computed tomography (MDCT).Materials and methodsThis retrospective study enroled 21 patients to evaluate the sensitivity, specificity and accuracy of 18FDG-PET/CT and MDCT. The results of the two techniques were compared with the Mc Nemar test. Cohen’s K was used to compare concordance at the different lesion sites.ResultsThe sensitivity, specificity and accuracy of 18FDG-PET/CT were 80, 66.67, and 76.19 %, respectively. The sensitivity, specificity and accuracy of MDCT were 93.33, 33.33, and 76.19 %, respectively. In 16 patients who underwent whole-body MDCT, the sensitivity, specificity and accuracy values were 91.67, 81.25, and 50 % (MDCT) and 100, 50, and 87.5 % (18FDG-PET/CT).Conclusions18FDG-PET/CT is useful in evaluating the extent of sarcoidosis and recognising lesions at different sites, including lymph nodes, lungs, liver, spleen and bone. It also improves the interpretation of the morphological lesions seen on MDCT and depicts a larger number of lesions. Therefore, 18FDG-PET/CT could be used to complement other more traditional techniques for the restaging and follow-up in patients with sarcoidosis.

[1]  A. Alavi,et al.  Evolving role of positron emission tomography in the management of patients with inflammatory and other benign disorders. , 2004, Seminars in nuclear medicine.

[2]  T. Werner,et al.  Clinical Utility of FDG–PET and PET/CT in Non-malignant Thoracic Disorders , 2011, Molecular Imaging and Biology.

[3]  Pek-Lan Khong,et al.  Whole-body PET/CT scanning: estimation of radiation dose and cancer risk. , 2009, Radiology.

[4]  Y. Nishiyama,et al.  Comparative evaluation of 18F-FDG PET and 67Ga scintigraphy in patients with sarcoidosis. , 2006, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[5]  N. Tamaki,et al.  Extensive FDG uptake and its modification with corticosteroid in a granuloma rat model: an experimental study for differentiating granuloma from tumors , 2007, European Journal of Nuclear Medicine and Molecular Imaging.

[6]  P. Grenier,et al.  Sarcoidosis activity: correlation of HRCT findings with those of 67Ga scanning, bronchoalveolar lavage, and serum angiotensin-converting enzyme assay. , 1998, Journal of computer assisted tomography.

[7]  P. Grenier,et al.  Sarcoidosis with pulmonary fibrosis: CT patterns and correlation with pulmonary function. , 2000, AJR. American journal of roentgenology.

[8]  N. Müller,et al.  Pulmonary sarcoidosis: changes on follow-up CT examination. , 1992, AJR. American journal of roentgenology.

[9]  P. Geusens,et al.  F-18 FDG PET/CT for Detecting Bone and Bone Marrow Involvement in Sarcoidosis Patients , 2012, Clinical nuclear medicine.

[10]  A. Constantinesco,et al.  18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases , 2008, European Journal of Nuclear Medicine and Molecular Imaging.

[11]  C. Rhodes,et al.  Fluorine-18 deoxyglucose uptake in sarcoidosis measured with positron emission tomography , 2004, European Journal of Nuclear Medicine.

[12]  Abass Alavi,et al.  Positron emission tomography imaging in nonmalignant thoracic disorders. , 2002, Seminars in nuclear medicine.

[13]  P. Grenier,et al.  Pulmonary sarcoidosis: CT assessment of lesion reversibility. , 1992, Radiology.

[14]  D. Hansell,et al.  Pulmonary sarcoidosis: morphologic associations of airflow obstruction at thin-section CT. , 1998, Radiology.

[15]  Ernst J Rummeny,et al.  Value of diffusion-weighted MR imaging in the differentiation between benign and malignant cervical lymph nodes. , 2009, European journal of radiology.

[16]  J. Talbot,et al.  Impact of [18F]-fluorodeoxyglucose ([18F]-FDG) imaging in sarcoidosis: unsuspected neurosarcoidosis discovered by [18F]-FDG PET and early metabolic response to corticosteroid therapy. , 2007, The British journal of radiology.

[17]  W. Kinnear,et al.  British Thoracic Society Standards of Care Committee , 2014 .

[18]  P. Lewis,et al.  Uptake of fluorine-18-fluorodeoxyglucose in sarcoidosis. , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  J. Watarai,et al.  The CT findings of pulmonary sarcoidosis. , 1996, The Tohoku journal of experimental medicine.

[20]  R. Dengler,et al.  Fluorodeoxyglucose positron emission tomography (FDG-PET) is useful in the diagnosis of neurosarcoidosis , 2009, Journal of the Neurological Sciences.

[21]  H. Nunes,et al.  Imagerie de la sarcoïdose pulmonaire , 2011 .

[22]  N. Sunaga,et al.  Value of FDG positron emission tomography in monitoring the effects of therapy in progressive pulmonary sarcoidosis. , 2007, Clinical nuclear medicine.

[23]  F. Chowdhury,et al.  Multi-technique imaging of sarcoidosis. , 2010, Clinical radiology.

[24]  A. Alavi,et al.  Is there a role for FDG PET imaging in the management of patients with sarcoidosis? , 1994, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[25]  E. O’Connor,et al.  Mediastinoscopy in patients with presumptive stage I sarcoidosis: a risk/benefit, cost/benefit analysis. , 1998, Chest.

[26]  M. Kataoka,et al.  Radiologic manifestations of sarcoidosis in various organs. , 2004, Radiographics : a review publication of the Radiological Society of North America, Inc.

[27]  S. Mimura,et al.  [Pulmonary involvement in sarcoidosis: CT findings at diagnosis and their changes at follow-up in cases without corticosteroid treatment]. , 2002, Nihon Kokyuki Gakkai zasshi = the journal of the Japanese Respiratory Society.

[28]  F. Gleeson,et al.  Re: Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern , 2010 .

[29]  M. Iannuzzi,et al.  Results of 188 whole-body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. , 2007, Chest.

[30]  J. Verschakelen,et al.  Inflammatory activity assessment by F18 FDG-PET/CT in persistent symptomatic sarcoidosis. , 2011, Respiratory medicine.

[31]  J. Shepard,et al.  Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT. , 2008, AJR. American journal of roentgenology.

[32]  B. Nguyen F-18 FDG PET imaging of disseminated sarcoidosis. , 2007, Clinical nuclear medicine.

[33]  T. Loehrl,et al.  Inflammatory and granulomatous lesions of the larynx and pharynx. , 2001, The American journal of medicine.

[34]  A. Wells,et al.  Interstitial lung disease guideline , 2008, Thorax.

[35]  A. Alavi,et al.  Gallium-67-citrate scanning in the assessment of disease activity in sarcoidosis. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[36]  Y. Mimori Sarcoidosis: correlation of HRCT findings with results of pulmonary function tests and serum angiotensin-converting enzyme assay. , 1998, The Kurume medical journal.

[37]  F. Gleeson,et al.  Sarcoid-like reaction to malignancy on whole-body integrated (18)F-FDG PET/CT: prevalence and disease pattern. , 2009, Clinical radiology.

[38]  L. Fasano,et al.  18F-FDG PET/CT detects systemic involvement in sarcoidosis , 2011, European Journal of Nuclear Medicine and Molecular Imaging.

[39]  陶仲为 Sarcoidosis , 2009 .

[40]  F. Mottaghy,et al.  Use of integrated FDG-PET/CT in sarcoidosis. , 2008, Clinical imaging.

[41]  G. Treglia,et al.  Emerging role of whole-body 18F-fluorodeoxyglucose positron emission tomography as a marker of disease activity in patients with sarcoidosis: a systematic review. , 2011, Sarcoidosis, vasculitis, and diffuse lung diseases : official journal of WASOG.