Total Body FDG Pet Scans in Sarcoidosis

Chest, 2007

Background: To study the role of whole-body 18 F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scans in the identification of occult biopsy sites and reversible granulomatous disease in patients with sarcoidosis. Methods: A retrospective review was undertaken of 188 FDG PET scans performed in 137 patients with proven sarcoidosis. All patients had given a complete medical history and undergone a physical examination, standard chest radiograph, spirometry, diffusing capacity determination, and measurement of serum angiotensin-converting enzymes levels. Results: One hundred thirty-nine whole-body scans had positive findings. The most common positive sites were mediastinal lymph nodes (54 scans), extrathoracic lymph nodes (30 scans), and lung (24 scans). The standardized uptake value (SUV) ranged from 2.0 to 15.8. Twenty occult disease sites were identified. Eleven repeat scans exhibited decreased SUV with corticosteroid therapy. The positive pulmonary FDG PET scan findings occurred in two thirds of patients with radiographic stage II and III sarcoidosis. Negative pulmonary FDG PET scan findings were common in patients with radiographic stage 0, I, and IV sarcoidosis. Conclusions: Whole-body FDG PET scans are of value in identifying occult and reversible granulomas in patients with sarcoidosis. However, a positive FDG PET scan finding, by itself, is not an indication for treatment.

Current opinion in pulmonary medicine, 2013

It is important to gain knowledge and understanding about the appropriate use of PET scan in the management of sarcoidosis patients. This means that, in view of the radiation dose and costs, defining appropriate indications for PET scanning in sarcoidosis patients is vital. PET has been shown to be a very sensitive technique for the assessment of inflammatory activity in sarcoidosis by detecting and quantifying the degree of inflammatory and granulomatous reactions that occur in the lungs and elsewhere in the body. PET is not indicated in the standard workup, but can be of great value to complement more routinely used techniques. On the basis of the current findings, PET offers added value in sarcoidosis patients with unexplained persistent disabling symptoms. PET appears especially helpful in those persistently symptomatic patients without serological signs of inflammatory activity, in patients with radiologic signs of fibrosis and in the detection of active cardiac sarcoidosis. Th...

Journal of Nuclear Medicine, 2012

Journal of Nuclear Cardiology, 2011

Monaldi Archives for Chest Disease, 2020

A 67-year-old male presented with cutaneous rash, lassitude and fatigue of three weeks. Personal history included psoriasis and sarcoidosis. Physical examination revealed macular rash on the anterior chest wall. Laboratory results were within normal limits. Chest X-ray showed normal findings. Pulmonary function tests demonstrated a mild obstructive pattern and a mild decrease in DLCO/VA. Thorax CT revealed two nodules in the right upper and middle lobe. 68Ga-citrate PET/CT did not demonstrate any active inflammatory reaction associated with sarcoidosis while 18F-FDG PET/CT revealed increased FDG uptake in the right middle lobe, upper division bronchus and in the left lower abdominal quadrant. Histopathologic examination of the colon biopsy was compatible with adenocarcinoma and bronchoscopic biopsy of the lung lesions revealed nonspecific granulomatous inflammation. BAL cytology was normal while BAL culture did not grow any pathologic organisms. Simultaneous use of 18F-FDG and 68Ga-...

Respiratory Medicine, 2013

M. Drent). URL: http://www.ildcare.eu. a v a i l a b l e a t w w w . s c i e n c e d i r e c t . c o m j o u r n a l h o m e p a g e : w w w . e l s e v i e r . c o m / l o c a t e / r m e d Respiratory Medicine (2011) 105, 1917e1924

Lung India : official organ of Indian Chest Society, 2014

Radionuclide imaging modalities have increasingly been evaluated in the assessment of organ involvement in sarcoidosis. Fluoro-deoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) scanning has received increasing attention in the recent years. The aim of our study was to evaluate the utility of FDG-PET-CT in determining the extent of organ involvement and disease activity in patients of sarcoidosis and to assess its utility in the evaluation of response to therapy. The secondary objective was to compare the agreement between clinical, radiological (HRCT) and metabolic indices (FDG-PET-CT) of disease activity. This was a prospective observational study conducted between March 2007 and December 2008 at a tertiary care referral center in north India. Twenty-five symptomatic and histopathologically proven cases of sarcoidosis underwent FDG-PET-CT scanning at baseline and a follow-up scan in 21 patients at 6-9 months post-treatment with glucocorticoids. FDG-PET-CT s...

International Journal of Cardiovascular Sciences, 2020

Cardiac sarcoidosis (CS) is a rare and potentially fatal condition, characterized by the presence of non-necrotizing granulomatous inflammation and concomitant fibrosis. A variety of clinical manifestation has been described, such as conduction disorders, ventricular arrythmias, congestive heart failure and sudden cardiac death, making a prompt diagnosis and early treatment desirable. Endomyocardial biopsy is the gold-standard diagnostic test, but has a low sensitivity due to the multifocal aspect of the disease. Advanced imaging modalities, such as cardiac magnetic resonance and positron emission tomography (PET) with 18F-fluorodeoxyglucose are now part of the diagnostic criteria and also assist in determining treatment response. However, the interpretation of those studies can be challenging and needs to be made by specialists, as the misdiagnosis could be harmful for the patient. This article describes the pathophysiology of CS and advanced imaging modalities (with a major focus on PET) that should be considered for diagnostic approach and therapy monitoring. Also, newer clinical trials evaluating treatment strategies are described.

European Journal of Nuclear Medicine and Molecular Imaging, 2008

Purpose To evaluate the interest of 18 F-fluoro-2-deoxy-Dglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) for diagnosis and therapeutic follow-up of patients with sarcoidosis. Methods Twenty consecutive patients with biopsy-proven sarcoidosis were retrospectively included, in particular, 13 and seven cases of thoracic and extra-thoracic sarcoidosis, respectively. All patients underwent 18 F-FDG PET/CT, and 12 of them also 67 Ga scintigraphy. Five patients were reexamined by 18 F-FDG PET/CT to assess response to corticosteroid (CS) treatment. Results Sensitivity of 18 F-FDG PET/CT in detecting active sarcoidosis localizations was determined considering only biopsy-proven sites. For thoracic, sinonasal, and pharyngolaryngeal localizations, 18 F-FDG PET/CT sensitivity was 100%, 100%, and 80%, respectively. Overall sensitivity for all 36 biopsy-proven localizations improved from 78% to 87% after excluding skin involvement. Considering only the 12 patients who underwent both scintigraphic examinations, overall sensitivity of 67 Ga scintigraphy and 18 F-FDG PET/CT was 58% and 79%, respectively and improved to 67% and 86% after excluding all sites of skin involvement. To evaluate the efficacy of CS treatment, five enrolled patients underwent second 18 F-FDG PET/CT. Complete regression of all foci of pathological tracer uptake was showed in two cases, permitting CS withdrawal after 2 and 6 months. Improvement but incomplete regression of mediastino-pulmonary disease occurred in two patients treated with CS for 19 and 21 months. Disease progression was assessed in one patient treated with decreasing doses of CS during 16 months. Conclusion 18 F-FDG PET/CT allows to obtain a complete morpho-functional cartography of inflammatory active localizations and to follow treatment efficacy in patients with sarcoidosis, particularly in atypical, complex, and multisystemic forms.

Money, Coinage and Colonialism: Entangled Exchanges, 2024

Book description: This book explores coinage and related object types as an important form of material culture that is crucial to interrogating interactions between coloniser and colonised. Money, Coinage and Colonialism is a much overdue treatment of coinage and money in debates around ancient and recent colonial practices. It argues that coinage offers unique opportunities to study interactions and effects of the meeting between colonisers and colonised, as well as the economic, political and ideological interactions between colonial communities and the state of origin. It is argued that the study of coins and other means of exchange may reveal less apparent and under-communicated processes, values and discourses in the study of colonial environments and projects, with commonalities informing a larger "global history" approach. A broad picture is built from numerous case studies, spanning from Classical Greek colonies to European colonial enterprises of the Modern period, exploring colonial histories, settings, ideology and resistance. Particular attention is paid to the role of coins in identity construction; to ambiguity, hybridity and creolisation of monetary objects in colonial contexts; and to specific uses of coins that tell of violence, oppression and resistance as well as of networks, acculturation and globalisation. Composed of chronologically broad and diverse case studies from colonial contexts, this book is for researchers in colonial and post-colonial archaeology as well as archaeological and cultural-historical numismatics.