Use of PET-CT for the assessment of treatment results in patients with sarcoidosis

Yakar, Aysun; Yakar, Fatih; Sezer, Murat; Bayram, Mehmet; Erdoğan, Ergun; Özkan, Didem; Özçelik, Hatice Kutbay; Tabak, Levent

doi:10.1007/s00508-014-0647-9

Cited by 6 publications

(1 citation statement)

References 21 publications

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“…Positron emission tomography scan can be a useful tool to detect the extent of the disease, identify multisystem disease such as cardiac sarcoidosis, and may help to identify a desirable site for biopsy [5]. Moreover, it could be invaluable in the decision to initiate immunosuppression and assess the efficacy of treatment [6,7]. Furthermore, it may help in predicting relapse in pulmonary sarcoidosis [8].…”

Section: Positron Emission Tomography Scanmentioning

confidence: 99%

Current Diagnostic Techniques in Sarcoidosis

Anandavelu¹,

Fahim²

2020

Sarcoidosis and Granulomatosis - Diagnosis and Management

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Sarcoidosis is an enigmatic disorder with a propensity for lung involvement in the majority of cases (~90%) and is characterized by noncaseating granulomatous inflammation on histological analysis. The techniques to establish the diagnosis have evolved over time, and a clear diagnostic algorithm for the clinicians dealing with this disease is desirable. Thoracic computed tomography is the imaging modality of choice in pulmonary sarcoidosis and provides accurate assessment of staging, parenchymal involvement, and response to immunomodulatory therapies. The advent of EBUS-TBNA has been a step forward with an excellent diagnostic yield in the presence of mediastinal/hilar lymphadenopathy and has replaced the traditional approach of obtaining biopsy samples via transbronchial and endobronchial routes. The preferred initial investigation for the confirmation of diagnosis is dependent on the organ involvement and the expertise available. A core biopsy of cervical lymph nodes is a less invasive and economical alternative in selected cases of suspected pulmonary sarcoidosis and warrants further evaluation in prospective manner to establish if it can be considered as a first-line investigation in all new cases suspected to have pulmonary sarcoidosis. A multidisciplinary approach is crucial for the diagnosis and management, and a simplified algorithm is proposed to help guide clinicians dealing with this disease of myriad clinical and radiological manifestations.

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Section: Positron Emission Tomography Scanmentioning

confidence: 99%

Current Diagnostic Techniques in Sarcoidosis

Anandavelu¹,

Fahim²

2020

Sarcoidosis and Granulomatosis - Diagnosis and Management

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Meta-analysis of [18F]FDG-PET/CT in pulmonary sarcoidosis

Donnelly,

McDermott,

McManus

et al. 2024

Eur Radiol

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Background 18F-Fluorodeoxyglucose (FDG) PET/CT is emerging as a tool in the diagnosis and evaluation of pulmonary sarcoidosis, however, there is limited consensus regarding its diagnostic performance and prognostic value. Method A meta-analysis was conducted with PubMed, Science Direct, MEDLINE, Scopus, and CENTRAL databases searched up to and including September 2023. 1355 studies were screened, with seventeen (n = 708 patients) suitable based on their assessment of the diagnostic performance or prognostic value of FDG-PET/CT. Study quality was assessed using the QUADAS-2 tool. Forest plots of pooled sensitivity and specificity were generated to assess diagnostic performance. Pooled changes in SUVmax were correlated with changes in pulmonary function tests (PFT). Results FDG-PET/CT in diagnosing suspected pulmonary sarcoidosis (six studies, n = 400) had a pooled sensitivity of 0.971 (95%CI 0.909–1.000, p = < 0.001) and specificity of 0.873 (95%CI 0.845–0.920)(one study, n = 169). Eleven studies for prognostic analysis (n = 308) indicated a pooled reduction in pulmonary SUVmax of 4.538 (95%CI 5.653–3.453, p = < 0.001) post-treatment. PFTs displayed improvement post-treatment with a percentage increase in predicted forced vital capacity (FVC) and diffusion capacity of the lung for carbon monoxide (DLCO) of 7.346% (95%CI 2.257–12.436, p = 0.005) and 3.464% (95%CI -0.205–7.132, p = 0.064), respectively. Reduction in SUVmax correlated significantly with FVC (r = 0.644, p < 0.001) and DLCO (r = 0.582, p < 0.001) improvement. Conclusion In cases of suspected pulmonary sarcoidosis, FDG-PET/CT demonstrated good diagnostic performance and correlated with functional health scores. FDG-PET/CT may help to guide immunosuppression in cases of complex sarcoidosis or where treatment rationalisation is needed. Clinical relevance statement FDG-PET/CT has demonstrated a high diagnostic performance in the evaluation of suspected pulmonary sarcoidosis with radiologically assessed disease activity correlating strongly with clinically derived pulmonary function tests. Key Points In diagnosing pulmonary sarcoidosis, FDG-PET/CT had a sensitivity and specificity of 0.971 and 0.873, respectively. Disease activity, as determined by SUVmax, reduced following treatment in all the included studies. Reduction in SUVmax correlated with an improvement in functional vital capacity, Diffusion Capacity of the Lungs for Carbon Monoxide, and subjective health scoring systems.

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