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Research ArticleCLINICAL INVESTIGATIONS

Comparative Evaluation of 18F-FDG PET and 67Ga Scintigraphy in Patients with Sarcoidosis

Yoshihiro Nishiyama, Yuka Yamamoto, Kotaro Fukunaga, Hiroyuki Takinami, Yasuyoshi Iwado, Katashi Satoh and Motoomi Ohkawa
Journal of Nuclear Medicine October 2006, 47 (10) 1571-1576;
Yoshihiro Nishiyama
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Yuka Yamamoto
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Kotaro Fukunaga
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Hiroyuki Takinami
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Yasuyoshi Iwado
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Katashi Satoh
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Motoomi Ohkawa
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    FIGURE 1. 

    67Ga scintigraphy and 18F-FDG PET images of 70-y-old woman with pulmonary and extrapulmonary sarcoidosis (patient 10 in Table 1). (A) Anterior and posterior 67Ga whole-body images show no abnormal uptake. (B) 18F-FDG PET image shows increased uptake at mediastinal and bilateral hila. (C) Increased uptake is also observed at left upper thigh on 18F-FDG PET image.

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    TABLE 1

    Guideline for Diagnosis of Cardiac Sarcoidosis from The Japanese Ministry of Health and Welfare (15)

    Histologic diagnosis group
     Cardiac sarcoidosis is diagnosed when histologic analysis of operative or endomyocardial biopsy specimens demonstrates epithelioid granuloma without caseating granuloma
    Clinical diagnosis group
     In patients with histologic diagnosis of extracardiac sarcoidosis, cardiac sarcoidosis is diagnosed when item (a) and 1 or more of items (b–e) are present:
    • (a) Complete right bundle branch block, left-axis deviation, atrioventricular block, ventricular tachycardia, premature ventricular contraction (>grade 2 in Lown's classification), or abnormal Q or ST–T change on electrocardiogram or Holter electrocardiogram

    • (b) Abnormal wall motion, regional wall thinning or thickening, or dilatation of left ventricle on echocardiogram

    • (c) Perfusion defect on 201Tl myocardial scintigram or abnormal accumulation on 67Ga-citrate or 99mTc-pyrophosphate myocardial scintigram

    • (d) Abnormal intracardiac pressure, low cardiac output, or abnormal wall motion or depressed ejection fraction of left ventricle

    • (e) Interstitial fibrosis or cellular infiltration over moderate grade in endomyocardial biopsy even if findings are nonspecific

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    TABLE 2

    18F-FDG PET and 67Ga Scintigraphy Findings in 18 Patients with Sarcoidosis

    Pulmonary sitesExtrapulmonary sites
    18F-FDG67Ga planar67Ga SPECT, visual18F-FDG67Ga planar
    Patient no.Age (y)SexLesionVisualSUVVisualL/N ratioLesionVisualSUVVisualL/N ratio
    163FMediastinal/hilar LN+10.52+1.46+Salivary gland−+1.11
    Pulmonary parenchyma+5.72+0.93+Supraclaviclar LN+5.67+1.27
    Muscle+4.51+0.88
    269FMediastinal/hilar LN+7.71+1.74+Axillary LN+3.76−
    Heart+11.64+1.10
    342MMediastinal/hilar LN+5.71−−Heart+6.89−
    Muscle+3.26+0.95
    442MMediastinal/hilar LN+5.99+1.44+Heart+6.44+1.01
    538MMediastinal/hilar LN+5.52+1.88+Heart+5.03−
    Pulmonary parenchyma+4.33+0.89+Inguinal LN+4.79−
    Muscle+3.06−
    629MMediastinal/hilar LN+12.46+5.26+Salivary gland−+1.98
    Supraclaviclar LN+7.62+1.14
    Paraaortic LN+7.06−
    Muscle+4.62−
    751FMediastinal/hilar LN+11.79+2.64+
    Pulmonary parenchyma+9.51+1.32+
    869MMediastinal/hilar LN+7.00+1.82+
    964FMediastinal/hilar LN+7.52+2.33+
    Pulmonary parenchyma+4.42+0.80+
    1070FMediastinal/hilar LN+9.95−−Muscle+5.51−
    1173FMediastinal/hilar LN+6.63+3.58+
    1260MMediastinal/hilar LN+8.73+2.05+
    1357FMediastinal/hilar LN+4.12+1.47+Salivary gland+3.46+1.45
    1445FMediastinal/hilar LN+9.63+2.25+Heart+9.84+1.00
    Supraclaviclar LN+6.98+1.38
    Paraaortic LN+6.71+1.64
    Inguinal LN+4.25+0.78
    Skin+2.87−
    1568FMediastinal/hilar LN+7.66−−Supraclaviclar LN+6.80−
    Heart+8.48−
    Skin+2.17−
    1668FMediastinal/hilar LN+5.47+1.65+Heart+6.31−
    Muscle+3.01+0.80
    1782FMediastinal/hilar LN+5.05−−Inguinal LN+2.17−
    Skin+12.94+1.03
    Spleen+9.35−
    1840FStomach−−
    • LN = lymph node; + = abnormal uptake; − = no uptake.

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Journal of Nuclear Medicine: 47 (10)
Journal of Nuclear Medicine
Vol. 47, Issue 10
October 2006
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Comparative Evaluation of 18F-FDG PET and 67Ga Scintigraphy in Patients with Sarcoidosis
Yoshihiro Nishiyama, Yuka Yamamoto, Kotaro Fukunaga, Hiroyuki Takinami, Yasuyoshi Iwado, Katashi Satoh, Motoomi Ohkawa
Journal of Nuclear Medicine Oct 2006, 47 (10) 1571-1576;

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Comparative Evaluation of 18F-FDG PET and 67Ga Scintigraphy in Patients with Sarcoidosis
Yoshihiro Nishiyama, Yuka Yamamoto, Kotaro Fukunaga, Hiroyuki Takinami, Yasuyoshi Iwado, Katashi Satoh, Motoomi Ohkawa
Journal of Nuclear Medicine Oct 2006, 47 (10) 1571-1576;
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