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Related Concept Videos

Imaging Studies II: Positron Emission Tomography and Scintigraphy01:25

Imaging Studies II: Positron Emission Tomography and Scintigraphy

Positron Emission Tomography (PET) is a medical imaging technique that provides crucial insights into the body's physiological functions at a molecular level. It is an indispensable resource for diagnosing, staging, and monitoring various illnesses, notably cancer, neurological disorders, and cardiovascular conditions.
Fundamental Principles of PET
Positron Emission Tomography01:29

Positron Emission Tomography

Positron emission tomography (PET) is a medical imaging technique involving radiopharmaceuticals — substances that emit short-lived radiation. Although the first PET scanner was introduced in 1961, it took 15 more years before radiopharmaceuticals were combined with the technique and revolutionized its potential.
One of the main requirements of a PET scan is a positron-emitting radioisotope, which is produced in a cyclotron and then attached to a substance used by the part of the body being...
Radiological Investigation III: Pulmonary Angiogram and PET Scan01:13

Radiological Investigation III: Pulmonary Angiogram and PET Scan

Radiological investigations are paramount in the diagnosis and management of various pulmonary diseases. Two essential investigations are the Pulmonary Angiogram and the Positron Emission Tomography (PET) Scan.
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...

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Related Experiment Video

Updated: May 26, 2026

Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
10:28

Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT

Published on: January 22, 2018

1-2-3-4 Sign FDG PET Sign in Sarcoidosis.

Luke Cassidy1, Vinuri Edirisinghe2, Sepinoud Firouzmand3

  • 1Community and Oral Health - Hospital in the Home, Brisbane, Australia.

Journal of Medical Imaging and Radiation Oncology
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

The lambda sign on FDG PET/CT is common in sarcoidosis. While periportal and portocaval lymphadenopathy can occur, the complete 1-2-3-4 sign is rare, aiding diagnosis.

Keywords:
1–2‐3 sign1–2–3‐4 signFDG PET/CTSUVmaxgranulomatous diseaselambda signperiportal lymph nodesportocaval lymph nodessarcoidosis

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Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
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Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
10:04

Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates

Published on: September 5, 2017

Area of Science:

  • Radiology
  • Nuclear Medicine
  • Oncology

Background:

  • Sarcoidosis is a multisystem granulomatous disease often affecting the lungs and lymph nodes.
  • Characteristic imaging findings like the lambda sign on FDG PET/CT can suggest sarcoidosis.
  • FDG PET/CT is valuable for assessing disease extent and guiding treatment.

Purpose of the Study:

  • To define the prevalence and imaging characteristics of the lambda sign and 1-2-3-4 sign in sarcoidosis.
  • To analyze FDG-avid periportal and portocaval lymphadenopathy in sarcoidosis patients.
  • To evaluate the diagnostic utility of these findings in differentiating sarcoidosis.

Main Methods:

  • Retrospective analysis of FDG PET/CT scans from sarcoidosis patients.
  • Assessment for the presence of the lambda sign and FDG-avid periportal/portocaval lymph nodes.
  • Analysis of nodal distribution, metabolic activity (SUVmax), and frequency of the 1-2-3-4 sign.

Main Results:

  • The lambda sign was identified in a significant portion of patients.
  • FDG-avid periportal and/or portocaval lymph nodes were observed in a subset of cases.
  • The complete 1-2-3-4 sign was rare; however, periportal/portocaval nodes showed FDG uptake similar to intrathoracic nodes.

Conclusions:

  • FDG-avid periportal and portocaval lymphadenopathy can be present in sarcoidosis, complementing typical intrathoracic findings.
  • The complete 1-2-3-4 sign is uncommon in sarcoidosis.
  • Recognizing these FDG PET/CT patterns enhances diagnostic confidence and helps differentiate sarcoidosis from other causes of lymphadenopathy.