Advanced imaging in sarcoidosis

Sarcoidosis remains a challenging disease to diagnose and treat, with a lack of reliable biomarkers to aid in diagnosis and prognosis. Advanced imaging techniques have potential to provide prognostic information and aid in the management of sarcoidosis. Here, we review recent data on the use of these techniques in the assessment and management of sarcoidosis.

FDG-PET is increasingly discovering previously occult involvement of sarcoidosis, and a recent expert survey suggests there is little agreement regarding the clinical significance of these findings. Retrospective studies have found associations of some clinical features with FDG-PET findings. FDG activity in pulmonary sarcoidosis may be associated with progression; however, better understanding of the implications of specific imaging features is needed. Liver elastography (ultrasound or MRI) may be a useful tool for identifying hepatic sarcoid patients at risk of progression and for noninvasive disease monitoring.

Advanced imaging techniques such as FDG-PET, MRI, and ultrasound have significant potential to improve outcomes in sarcoidosis patient. However, there remains a lack of data and consensus regarding the role of these techniques in the management of patients with sarcoidosis. More longitudinal cohort data are needed to better apply these advanced imaging techniques in sarcoidosis.