18F-FDG PET successfully detects spinal cord sarcoidosis

Area of Science:

• Neurology
• Nuclear Medicine
• Radiology

Background:

• Diagnosing neurosarcoidosis, particularly spinal cord involvement, remains challenging despite various evaluation methods.
• While 18F-FDG PET is recognized for detecting sarcoid lesions, its utility in the central nervous system, especially the spinal cord, is under-explored.

Observation:

• Two patients with confirmed sarcoidosis presented with spinal symptoms.
• 18F-FDG PET scans revealed abnormal uptake in the spinal cords, which were not detected by gallium scintigraphy.
• These abnormal findings correlated with disease activity and treatment response.

Findings:

• 18F-FDG PET demonstrated superior sensitivity compared to gallium scintigraphy for identifying spinal cord sarcoidosis.
• Abnormal FDG uptake in the spinal cord diminished following treatment, indicating disease activity tracking.

Implications:

• 18F-FDG PET shows promise as a valuable tool for diagnosing and monitoring spinal cord sarcoidosis.
• This imaging modality may improve management strategies for patients with neurosarcoidosis affecting the spinal cord.