FDG-PET Scan in Sarcoidosis: Clinical and Imaging Indications

Author(s): Marica T. Maccarone*

Journal Name: Current Medical Imaging
Formerly: Current Medical Imaging Reviews

Volume 15 , Issue 1 , 2019

Become EABM
Become Reviewer


Background: Sarcoidosis is an unknown etiology multisystem inflammatory disease in which noncaseating granulomas (a collections of inflammatory cells) form and grow in various organs, involving predominantly lungs, intrathoracic lymph node, skin and eyes. It most commonly affects patients between 20 and 40 years old of age but it could be observed at any age (female predominance; rare in Asians).

Discussion: The areas of the body usually affected by sarcoidosis are lungs, skin, or lymph nodes; pulmonary and mediastinal involvement is seen in over of 90% of patients. Less commonly eyes, liver, heart, and brain are involved. Any organ, however, can be affected.

Early diagnosis of sarcoidosis can be difficult due to few signs and symptoms in its early stages, and when disease does occur, it may mimic other pathologies, and is made up with chest X-ray, Computed Tomography (CT)-High Resolution CT (HRCT), gallium scans. Fluoro-Deoxy Glucose– Positron Emission Tomography (FDG-PET) is another useful tool to assess the extent of disease and has a potential to evaluate the clinical management of patients responding or not to the treatment.

Conclusion: In this review, we would summarize in brief the clinical indications of PDG-PET in sarcoidosis and report the imaging features of the main organs involved in this disease.

Keywords: FDG-PET, sarcoidosis, angiotensin converting enzyme, CT, inflammatory disease, lymph node.

Amin EN, Closser DR, Crouser ED. Current best practice in the management of pulmonary and systemic sarcoidosis. Ther Adv Respir Dis 2014; 8(4): 111-32.
Keijsers RG, Veltkamp M, Grutters JC. Chest Imaging. Clin Chest Med 2015; 36(4): 603-19.
Juan Mañá. Molecular imaging in sarcoidosis. Curr Opin Pulm Med 2011; 17(5): 325-31.
Greco FG, Spagnolo P, Muri M, et al. The value of chest radiograph and computed tomography in pulmonary sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2014; 31: 108-16.
Scadding JG. Prognosis of intrathoracic sarcoidosis in England. A review of 136 cases after five years’ observation. BMJ 1961; 2: 1165-72.
Basu S, Zhuang H, Torigian DA, Rosenbaum J, Chen W, Alavi A. Functional imaging of inflammatory diseases using nuclear medicine techniques. Semin Nucl Med 2009; 39(2): 124-45.
Maturu VN, Rayamajhi SJ, Agarwal R, Aggarwal AN, Gupta D, Mittal BR. Role of serial F-18 FDG PET/CT scans in assessing treatment response and predicting relapses in patients with symptomatic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33(4): 372-80.
Adams H, Keijsers RG, Korenromp IH, Grutters JC. FDG PET for gauging of sarcoid disease activity. Semin Respir Crit Care Med 2014; 35(3): 352-61.
Acar T, Savas R, Kocacelebi K, Ucan ES. Corticosteroid responsive sarcoidosis with multisystemic involvement years after initial diagnosis: A lymphoma mimicker on 18-FDG PET/CT. J Clin Imaging Sci 2015; 5: 40.
Soussan M, Augier A, Brillet PY, Weinmann P, Valeyre D. Functional imaging in extrapulmonary sarcoidosis: FDG-PET/CT and MR features. Clin Nucl Med 2014; 39(2): e146-59.
Palestro CJ, Love C. Decreased sensitivity of (18)F-fluorodeoxyglucose imaging in infection and inflammation. Semin Nucl Med 2012; 42(4): 261-6.
Ramachandraiah V, Aronow W, Chandy D. Pulmonary sarcoidosis: An update. Postgrad Med 2017; 129(1): 149-58.
Aleksonienė R, Zeleckienė I, Matačiūnas M, et al. Relationship between radiologic patterns, pulmonary function values and bronchoalveolar lavage fluid cells in newly diagnosed sarcoidosis. J Thorac Dis 2017; 9(1): 88-95.
Keijsers RG, Veltkamp M, Grutters JC. Chest imaging. Clin Chest Med 2015; 36(4): 603-19.
Skali H, Schulman AR, Dorbala S. 18F-FDG PET/CT for the assessment of myocardial sarcoidosis. Curr Cardiol Rep 2013; 15(4): 352.
Kataoka S, Momose M, Fukushima K, et al. Regional myocardial damage and active inflammation in patients with cardiac sarcoidosis detected by non-invasive multi-modal imaging. Ann Nucl Med 2017; 31(2): 135-43.
Zandieh S, Bernt R, Mirzaei S, Haller J, Hergan K. Image fusion between 18F-FDG PET and MRI in cardiac sarcoidosis: A case series. J Nucl Cardiol 2016; 25(4): 1128-34.
Vinas FC. Diagnosis and management of neurosarcoidosis. J Clin Neurosci 8(6): 505-13.
Matsumoto K, Ehara S, Sakaguchi M, Otsuka K, Hasegawa T, Shimada K. Clinical characteristics of late gadolinium enhancement in patients with cardiac sarcoidosis. Osaka City Med J 2015; 61(1): 9-17.
Vargas DL, Stern BJ. Neurosarcoidosis: Diagnosis and management. Semin Respir Crit Care Med 31(4): 419-27.
Tana C, Wegener S, Borys E, et al. Challenges in the diagnosis and treatment of neurosarcoidosis. Ann Med 2015; 47(7): 576-91.
Pawate S, Moses H, Sriram S. Presentations and outcomes of neurosarcoidosis: A study of 54 cases. QJM 2009; 102(7): 449-60.
Grozdic MI, Sobic-Saranovic D, Videnovic-Ivanov J, Saranovic D, Odalovic S, Artiko V. FDG PET/CT in bone sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33(1): 66-74.
Mostard RL, Prompers L, Weijers RE, et al. F-18 FDG PET/CT for detecting bone and bone marrow involvement in sarcoidosis patients. Clin Nucl Med 2012; 37(1): 21-5.
Conte G, Zugni F, Colleoni M, Renne G, Bellomi M, Petralia G. Sarcoidosis with bone involvement mimicking metastatic disease at (18)F-FDG PET/CT: Problem solving by diffusion whole-body MRI. Ecancermedicalscience 2015; 9: 537.

Rights & PermissionsPrintExport Cite as

Article Details

Year: 2019
Published on: 07 December, 2018
Page: [4 - 9]
Pages: 6
DOI: 10.2174/1573405614666180626120832
Price: $65

Article Metrics

PDF: 29