Severity of pulmonary involvement and 18F-FDG PET activity in sarcoidosis

Mostard, Rémy L M; Verschakelen, Johny; Kroonenburgh, M.J.P.G. van; Nelemans, Patty J.; Wijnen, Petal A.; Vöö, Stefan; Drent, Marjolein

doi:10.1016/j.rmed.2012.11.011

Cited by 93 publications

(61 citation statements)

References 35 publications

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“…There is also increasing interest in fluorodeoxyglucose-PET/computed tomography (FDG-PET CT) scans to detect metabolic activity in granulomas. Mostard et al retrospectively assessed 95 patients with sarcoidosis for whole body PET scan and HRCT findings (38). Overall, pulmonary PET positivity was detected in 56 patients (59%), and the vast majority of patients with fibrotic changes on HRCT had positive PET findings.…”

Section: Part Iii: Clinical Management Of Fibrotic Sarcoidosismentioning

confidence: 99%

From granuloma to fibrosis

Bonham

Strek²,

Patterson³

2016

Current Opinion in Pulmonary Medicine

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Purpose of review Up to twenty percent of patients with sarcoidosis develop pulmonary fibrosis, transforming an often benign disease into a highly morbid and potentially fatal one. We highlight the fibrotic pulmonary sarcoidosis phenotype as an area of intense clinical and translational investigation, review recent developments in treatment, and provide a roadmap for future research in sarcoidosis associated pulmonary fibrosis. Recent findings Granulomatous inflammation in a lymphatic distribution is the hallmark finding of pulmonary sarcoidosis and the nidus for fibrosis. Recent research demonstrates that fibrotic sarcoidosis begins in the setting of persistent, uncontrolled inflammation, and is aided by pro-fibrotic genetic features and immune responses. Comparison to other fibrotic lung diseases also reveals key features that inform our understanding of common pathways in fibrosis. Summary Understanding the mechanisms of fibrotic transformation in sarcoidosis enhances clinical care and facilitates development of novel therapeutic options. The impact of these findings in fibrotic sarcoidosis may be amplified through application to other interstitial lung diseases marked by inflammatory to fibrotic transformation. Important aspects of clinical management of fibrotic sarcoidosis include surveillance for co-morbidities, such as pulmonary hypertension, airway disease, and infection, and assessment for pulmonary disease activity that may benefit from immunosuppression.

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Section: Part Iii: Clinical Management Of Fibrotic Sarcoidosismentioning

confidence: 99%

From granuloma to fibrosis

Bonham

Strek²,

Patterson³

2016

Current Opinion in Pulmonary Medicine

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“…Whether or not masses are fibrotic cannot always be differentiated on HRCT. Only serial imaging or PET/CT can demonstrate if they are fibrotic or also represent active inflammatory disease [22]. These hilar masses were regarded as consolidations and scored as being central or peripheral in location.…”

Section: Discussionmentioning

confidence: 99%

Chest Computed Tomography-Based Scoring of Thoracic Sarcoidosis: Inter-rater Reliability of CT Abnormalities

et al. 2015

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Purpose To determine inter-rater reliability of sarcoidosisrelated computed tomography (CT) findings that can be used for scoring of thoracic sarcoidosis. Materials and methods CT images of 51 patients with sarcoidosis were scored by five chest radiologists for various abnormal CT findings (22 in total) encountered in thoracic sarcoidosis. Using intra-class correlation coefficient (ICC) analysis, inter-rater reliability was analysed and reported according to the Guidelines for Reporting Reliability and Agreement Studies (GRRAS) criteria. A pre-specified sub-analysis was performed to investigate the effect of training. Scoring was trained in a distinct set of 15 scans in which all abnormal CT findings were represented. Results Median age of the 51 patients (36 men, 70 %) was 43 years (range 26 -64 years). All radiographic stages were present in this group. ICC ranged from 0.91 for honeycombing to 0.11 for nodular margin (sharp versus illdefined). The ICC was above 0.60 in 13 of the 22 abnormal findings. Sub-analysis for the best-trained observers demonstrated an ICC improvement for all abnormal findings and values above 0.60 for 16 of the 22 abnormalities. Conclusions In our cohort, reliability between raters was acceptable for 16 thoracic sarcoidosis-related abnormal CT findings. Key Points• Thoracic sarcoidosis is common; knowledge on reliability of CT scoring is limited.• Scoring CT abnormalities in pulmonary sarcoidosis can achieve good inter-rater agreement.• CT scoring validation in thoracic sarcoidosis is important for diagnostic and prognostic studies.

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“…Several studies confirm these findings. [45] In addition, one study, reported 100% sensitivity of PET-CT for pulmonary and systemic sarcoidosis compared with 81% sensitivity for 67Ga scintigraphy/single photon emission computed tomography (SPECT) and showed positive PET-CT results in cases with negative 67Ga scans. [1] Thus, in our study 67Ga scan was not done.…”

Section: Discussionmentioning

confidence: 99%

Accuracy of Serial PET-CT Imaging in Systemic Sarcoidosis

Carbone

Penna²,

Baughman

et al. 2014

Journal of Clinical Imaging Science

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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.

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Severity of pulmonary involvement and 18F-FDG PET activity in sarcoidosis

Abstract: The severity of the pulmonary involvement, assessed by HRCT features and lung function parameters, appeared to be associated with PET activity in sarcoidosis. The majority of patients with fibrotic changes demonstrated inflammatory activity at pulmonary and extrathoracic sites.

Cited by 93 publications

References 35 publications

From granuloma to fibrosis

From granuloma to fibrosis

Chest Computed Tomography-Based Scoring of Thoracic Sarcoidosis: Inter-rater Reliability of CT Abnormalities

Accuracy of Serial PET-CT Imaging in Systemic Sarcoidosis

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