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Clinical Investigation |
1 Department of Radiology, Faculty of Medicine, Kagawa University, Kagawa, Japan; and 2 Second Department of Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan
Correspondence: For correspondence or reprints contact: Yoshihiro Nishiyama, MD, Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan. E-mail: nisiyosi{at}kms.ac.jp
67Ga scintigraphy has been used for years in sarcoidosis for diagnosis and the extent of the disease. However, little information is available on the comparison of 18F-FDG PET and 67Ga scintigraphy in the assessment of sarcoidosis. The purpose of this study was to compare the uptake of 18F-FDG and 67Ga in the evaluation of pulmonary and extrapulmonary involvement in patients with sarcoidosis. Methods: Eighteen patients with sarcoidosis were examined. 18F-FDG PET was performed at 1 h after injection of 185–200 MBq 18F-FDG. 67Ga whole-body planar and thoracic SPECT images were acquired 72 h after injection of 111 MBq 67Ga. We evaluated 18F-FDG and 67Ga uptake visually and semiquantitatively using standardized uptake values (SUVs) and the ratio of lesion to normal lumbar spine (L/N ratio), respectively. The presence of pulmonary and extrapulmonary lesions was evaluated histopathologically or by the radiologic findings. Results: Five patients had only pulmonary lesions, 12 patients had both pulmonary and extrapulmonary lesions, and 1 patient had only an extrapulmonary lesion. Both 67Ga planar and SPECT images detected 17 of 21 (81%) clinically observed pulmonary sites. The mean ± SD of the L/N ratio was 1.97 ± 1.09. 67Ga planar images detected 15 of 31 (48%) clinically observed extrapulmonary sites. The mean ± SD of the L/N ratio was 1.17 ± 0.33. 18F-FDG PET detected all 21 (100%) clinically observed pulmonary sites. The mean ± SD of the SUV was 7.40 ± 2.48. 18F-FDG PET detected 28 of 31 (90%) clinically observed extrapulmonary sites. The mean ± SD of the SUV was 5.90 ± 2.75. Conclusion: The results of this clinical study suggest that 18F-FDG PET can detect pulmonary lesions to a similar degree as 67Ga scintigraphy. However, 18F-FDG PET appears to be more accurate and contributes to a better evaluation of extrapulmonary involvement in sarcoidosis patients.
Key Words: 67Ga scintigraphy • 18F-FDG PET • sarcoidosis • extrapulmonary involvement
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