FDG PET imaging in sarcoidosis.

Area of Science:

• Nuclear Medicine
• Radiology
• Pulmonology

Background:

• Chronic sarcoidosis evaluation presents diagnostic challenges.
• Identifying active inflammation and extrathoracic involvement is crucial for patient management.

Purpose of the Study:

• To review the clinical utility of FDG-PET/CT in chronic sarcoidosis.
• To highlight advantages, disadvantages, and recommendations for FDG-PET/CT use.

Main Methods:

• Review of existing literature on FDG-PET/CT in sarcoidosis.
• Analysis of FDG accumulation in inflammatory cells and combined PET/CT imaging.

Main Results:

• FDG-PET/CT visualizes active inflammation and occult sarcoidosis sites (bones, liver, spleen, lymph nodes).
• It is valuable for staging, biopsy guidance, and assessing cardiac sarcoidosis, even in asymptomatic patients.
• The technique aids in treatment planning, response monitoring, and long-term follow-up.

Conclusions:

• FDG-PET/CT is a valuable tool for evaluating chronic sarcoidosis, particularly for extrathoracic disease and cardiac involvement.
• Limitations include potential "sarcoidosis-lymphoma syndrome" misdiagnosis and radiation exposure.
• Further multicenter studies are needed to refine clinical applications.