Clinical Utility of ¹⁸F-FDG PET/CT in the Work-up of Children with Uveitis

Abstract

Purpose: To evaluate 18 F-fluorodeoxyglucose Positron Emission Tomography/ultra low dose Computed Tomography ( 18 F-FDG PET/ ULD CT) in the work-up of pediatric uveitis. Methods: Retrospective study of 12 children followed for uveitis who underwent whole body 18 F-FDG PET/ULD CT between 2011 and 2019. Results: The average age of the patients was 11 years. A total of 100% of patients presented with bilateral uveitis, 50% had panuveitis and 92% had various choroidal involvement. Relevant information for diagnosis was provided in four patients. 5/12 had an abnormal 18F-FDG uptake. Of these, three patients had pathognomonic images of active granulomatous diseases. Three patients underwent PET CT-guided biopsies of which two were positive for sarcoidosis. Conclusion: 18 F-FDG PET/CT provided important information for final diagnosis in approximately 30% (4/ 12) of pediatric patients with bilateral uveitis. Whole body FDG PET/ULD CT can contribute to the final diagnosis thanks to pathognomonic image of active granulomatous disease and/or by indicating metabolically active site of biopsy that would not be visualized in thorax CT.

Ocular sarcoidosis in adults and children: update on clinical manifestation and diagnosis

“…In FDG PET CT and in Gallium-67 scintigraphy lambda sign and panda signs are used as characteristic signs [ 67 , 68 ] for diagnosis of sarcoidosis. Moreover, other sites of FDG intake can also be helpful for diagnosis by indicating locations for accessible biopsies [ 66 , 69 ] (Fig. 4 A, B).…”

“…In diagnosing bilateral uveitis of undetermined origin in children, FDG PET/ ultra-low dose CT provided important information for final diagnosis in 30% patients [ 69 ]. In this study, for three pediatric patients the extra thoracic FDG intake showed biopsy accessible sites (cervical, axillary or inguinal lymph nodes) and led in 2 patients to biopsy proven, PET-CT guided ocular sarcoidosis (Fig.…”