Abstract
18F-Fluorodeoxyglucose Positron Emission Tomography/ Computed Tomography (18F-FDG PET/CT) has revolutionized the diagnostic accuracy for the evaluation of sarcoidosis with significant clinical and therapeutic implications.We examined the role of 18F-FDG PET/CT at the detection of thoracic and extrathoracic manifestations of sarcoidosis as well as at the detection of unsuspected disease leading to therapeutic management reevaluation. All biopsy-proven sarcoidosis patients referred to our Pulmonary Medicine Department were evaluated. Epidemiological, clinical, laboratory and functional data were collected after informed consent. Patients further submitted to 18F-FDG-PET/CT were included in the study.35 patients, 22 female, mean age (54.0±14.4 ) years and stage 0, I, II, III, IV at 20.6%, 35.3%, 35.3%, 2.9% and 5.9% respectively were studied. Disease duration was 32.0 (11.0, 78.0) months and 51.4% of patients were under steroid treatment. Nineteen patients (54.3.%) revealed increased radiotracer uptake at the hilar and mesothoracic lymph nodes, 9 out of 35 (25.7%) at the lung parenchyma and 8 (22.9%) at both. Eleven patients (31.4%) presented with extrathoracic node uptake. 43% of Stage 0 patients presented extrathoracic manifestations. Half of Stage 1 patients presented with extrathoracic disease: nodes (16.7%,) GI (16.7%), muscles (16.7%), bone (25%) and skin (8.3%). Unsuspected was the detection of few but clinically meaningful cases of cardiac, musculoskeletal and ocular sarcoidosis. 18F-FDG-PET/CT frequently discloses unsuspected and undetectable, by other non-invasive means, pulmonary and especially Extra-pulmonary disease involvement and in a significant number of patients guides life-saving therapeutic decisions.
- © 2014 ERS