Accuracy of Serial PET-CT Imaging in Systemic Sarcoidosis

Abstract

Positron emission tomography (PET) in combination with computed tomography (PET-CT) is commonly used to identify malignant lesion in the lung. Despite there being only a few reports in literature, PET-CT imaging may have many advantages in the study of sarcoidosis, being useful in the diagnosis as well as in monitoring the response to treatment. The object of this case report is to highlight the clinical utility of integrated PET-CT imaging for evaluation of patients with systemic sarcoidosis and for comparing baseline findings to follow-up readings.

Systemic sarcoidosis mimicking malignant metastatic disease

“…Due to a hypermetabolic state in active sarcoidosis, 18-FDG-PET scanning is not able to distinguish between sarcoidosis and neoplastic disease. Therefore, it is only recommended as a follow-up monitoring examination in patients with already confirmed sarcoidosis ( 11 ).…”

In-111 octreotide SPECT/CT in the early diagnosis of pulmonary sarcoidosis: A case report

“…Positron emission tomography (PET)‐CT could be used to accurately assess disease activity in sarcoidosis patients, provides both a structural and functional lung assessment and is helpful in predicting pulmonary deterioration in untreated patients or pulmonary improvement expected after treatment [ 8 , 9 ]. The sensitivity of PET‐CT for pulmonary sarcoidosis is greater than that of 67Gallium scintigraphy and shows positive results in cases with negative 67 Gallium scintigraphy particularly when lymph nodes and spleen are involved [10] .…”

PET/CT findings in sarcoidosis: Analysis of 53 cases

“…Hastalarımızın ortalama ACE düzeyi 52.3 U/L saptanmıştır. ACE'nin sarkoidozda negatif prediktif değeri düşüktür (%60) ve hastalığın tanısında ve takibinde güvenilir olmadığı düşünülür 11,12 . Keijsers ve ark.…”

“…PET/BT esas olarak malign lezyonların tanı ve takibinde, onkolojide kullanılır. SUDmax değeri 2,5'in altında olması benign lezyonu düşündürür 12 . Sarkoidoz gibi inflamatuvar ve benign hastalıklarda yüksek FDG tutulumu (yüksek SUDmaks) aslında bir yalancı pozitiflik durumudur 12 .…”

“…SUDmax değeri 2,5'in altında olması benign lezyonu düşündürür 12 . Sarkoidoz gibi inflamatuvar ve benign hastalıklarda yüksek FDG tutulumu (yüksek SUDmaks) aslında bir yalancı pozitiflik durumudur 12 . Çalışmamızda, mediastinal LAP SUDmaks: 9.1 (0-22.7), akciğerde lezyon SUDmax:7.6 (0-25,5) değerlerinde yüksek bulunmuştur.…”