SPECT with 67Ga Citrate in the Diagnosis of Systemic Sarcoidosis

Abstract

Purpose: To study the possibilities of using 67Ga-citrate in patients with systemic manifestations of sarcoidosis to identify foci of pathological accumulation of the drug and assess the degree of process activity.
 Material and methods: Radionulide study with 67Ga-citrate was performed in 140 patients with respiratory sarcoidosis and suspected extrapulmonary localization. In addition, all patients underwent X-ray examination of the lungs, MSCT of the organs of the chest and abdominal cavity, SPECT of the lungs with radiopharmaceutical macroaggregates of albumin, ultrasound of the abdomen, pelvis, MRI of the head was performed in 16 patients with suspected neurosarcoidosis.
 Results: Most patients (n = 125) showed changes in the lungs, manifested by a bright glow (yellow or purple) on the computer screen, which indicated a pronounced impaired function of lymphoid tissue. In 22 patients, the changes were recurrent. The results correlated with published data on damage to the nervous system (r = 0.96), musculoskeletal system (r = 0.97), parotid glands (r = 0.91), liver, spleen (r = 0.83) . At the same time, the results for eye damage (r = 0.23), ENT organs (r = 0.15), intestines (r = 0.48) were significantly different. In our study, no heart lesions were detected in any case.
 Conclusions: The use of positive scintigraphy with Ga-67 citrate, taking into account the whole body scan and SPECT of areas of interest of interest (chest cavity, abdominal cavity, head, pelvis) is effective for the diagnosis of systemic sarcoidosis and in determining the activity of the process. The study is recommended to be performed 72 hours after intravenous administration of the drug.
 The combination of CT, MRI and radionuclide studies allows you to obtain reliable information about the activity of the process, to identify the localization of increased metabolic activity, that is, the topography of active sarcoidosis.