Abstract
Sarcoidosis is a granulomatous disease of which the etiology remains unknown. The diverse clinical manifestations may challenge clinicians, particularly when conventional markers are inconclusive. From various studies, it has become clear that fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT aids in sarcoidosis care. In this article, an update on FDG PET/CT in sarcoidosis is provided. The use of FDG PET/CT in the diagnostic process of sarcoidosis is explained, especially in determining treatable inflammatory lesions in symptomatic patients with indecisive conventional tests. Furthermore, FDG PET/CT for evaluating the potential benefit of additional inflammatory treatment is described and its use in cardiac sarcoidosis is highlighted.
Highlights
Sarcoidosis is a granulomatous disease of unknown etiology with heterogeneous clinical manifestations
FDG positron emission tomography (PET) can be used in leukocyte-mediated diseases, like sarcoidosis and other granulomatous disorders [3]
Active disease imaged by FDG PET/CT was found in 65 patients (73%) [41]
Summary
Sarcoidosis is a granulomatous disease of unknown etiology with heterogeneous clinical manifestations. Clinical features (e.g., erythema nodosum, uveitis, or changing scar due to localization of granulomas), biochemical markers (e.g., elevated serum angiotensin converting enzyme (ACE), serum or urine calcium, or lymphocytes in the bronchoalveolar lavage fluid), and abnormalities/changes in imaging (chest radiography, CT, or MRI) are conventionally used to assess (change of) disease activity. These markers have a limited diagnostic performance. FDG is transported into lymphocytes and macrophages through these GLUTs. FDG PET can be used in leukocyte-mediated diseases, like sarcoidosis and other granulomatous disorders [3]. Yamada et al [6] Nishiyama et al [10] Kaira et al [11] Teirstein et al [5] Prager et al [12] Braun et al [13] Keijsers et al [14] Keijsers et al [15] Keijsers et al [9] Maturu et al [16] Guleria et al [17] Simonen et al [7]
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