PURPOSE: PET scans are accepted as valuable aides in the diagnosis and staging of neoplastic diseases. However, FDG avidity is common also in granulomatous diseases and PET scanning has been reported to be positive in a growing number of patients with sarcoidosis.
METHODS: We have performed total body PET scans in 148 patients with biopsy proven sarcoidosis.
RESULTS: 98 had at least one site which was positive as evidenced by increased FDG uptake, with SUV's form 2-8. The following organs with PET positivity were identified: lungs 38, mediastinal lymph nodes 46, peripheral lymph nodes 36, abdominal lymph nodes 27, lacrimal and parotid glands 26, bones 14, liver and spleen 11, miscellaneous 16.
CONCLUSION: Many of the total body PET scans were performed at the time of Rb-80 and FDG scans seeking evidence of cardiac sarcoidosis. Total body PET scan positivity was common in patients with other clinical evidence of active granulomatous lesions while the scans tended to be negative or low SUV in patients with radiographic stable or fibrotic pulmonary sarcoidosis. There was no correlation with serum angiotensin converting enzyme levels.
CLINICAL IMPLICATIONS: Total body FDG PET scans for sarcoidosis were most valuable in: 1.identifying possible diagnostic biopsy sites2.as a guide to therapy in patients with evidence of pulmonary fibrosis (stage IV radiographs).
DISCLOSURE: Alvin Teirstein, None.