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Current Medical Imaging

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ISSN (Print): 1573-4056
ISSN (Online): 1875-6603

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Research Article

Diagnostic Performance of 18F-FDG PET/CT Semiquantitative Analysis in the Management of Sarcoidosis

Author(s): Giuseppe Rubini, Cristina Ferrari, Corinna Altini, Alessandra Cimino, Margherita Fanelli and Artor Niccoli Asabella*

Volume 15, Issue 1, 2019

Page: [32 - 38] Pages: 7

DOI: 10.2174/1573405614666180522075828

Price: $65

Abstract

Background: Sarcoidosis is a multisystem granulomatous disorder of unknown origin characterized by nonspecific clinical symptomatology. 18F-FDG PET/CT can visualize activated inflammatory cells of sarcoidosis and simultaneously provide whole-body images.

Objective: To evaluate the clinical usefulness of 18F-FDG PET/CT and its semiquantitative parameters for the assessment of treatment efficacy in patients with sarcoidosis.

Methods: Thirty-one consecutive patients who performed 18F-FDG PET/CT for sarcoidosis assessment were selected. All subjects performed 18F-FDG PET/CT before any treatment (PET1) and after 6-12 months (PET2). SUVmax and SUVmean on PET1 and PET2 were collected. SUVs values were employed to evaluate the ratios with the liver (R-LIVERmax, R-LIVERmean) and the blood (R-BLOODmax, R-BLOODmean). The difference between the PET1 and PET2 values was evaluated (ΔSUVmax, ΔSUVmean, ΔR-LIVERmax, ΔR-LIVERmean, ΔR-BLOODmax, ΔR-BLOODmean). Patients were classified as Responders (R), Partial-Responders (PR) and Non- Responders (NR).

Results: Seventeen patients (54.8%) had a complete metabolic response (R), 4 (12.9%) were PR while 10 (32.3%) had no Metabolic Response (NR). The chi-square test showed that response groups were related neither to the stage of disease (p=0.59) nor to therapy performed (p<0.079). The comparison between each Δ semiquantitative parameter showed a statistically significant decrease from PET1 to PET2 (0.0001 < p < 0.002). The comparison between Δ mean values in relation to response groups showed to be statistically significant (0.001 < p < 0.005). Conversely, they did not show statistical significance in relation to the clinical stage groups and to the kind of therapy performed (p>0.05). Pearson’s coefficient demonstrated a reverse correlation between a number of sites still involved in disease after therapy and each Δ semiquantitative parameters (p≤0.0001).

Conclusion: 18F-FDG PET/CT should be considered a useful technique for the evaluation of sarcoidosis and semiquantitative parameters. Further studies are needed to determine the long-term impact of 18F-FDG PET/CT on clinical outcomes.

Keywords: Sarcoidosis, treatment assessment, 18F-FDG PET/CT, semiquantitative parameters, ΔSUV, ΔR-LIVER, ΔR-BLOOD.

Graphical Abstract

[1]
Hunninghake GW, Costabel U, Ando M, et al. ATS/ERS/WASOG statement on sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 1999; 16: 149-73.
[2]
Iannuzzi MC, Rybicki BA, Teirstein AS. Sarcoidosis. N Engl J Med 2007; 357: 2153-65.
[3]
Sobic-Saranovic D, Grozdic I, Videnovic-Ivanov J, et al. The Utility of 18F-FDG PET/CT for diagnosis and adjustment of therapy in patients with active chronic sarcoidosis. J Nucl Med 2012; 53: 1-7.
[4]
Braun JJ, Kessler R, Constantinesco A, et al. 18F-FDG PET/CT in sarcoidosis management: Review and report of 20 cases. Eur J Nucl Med Mol Imaging 2008; 35(8): 1537-43.
[5]
Judson MA. The treatment of pulmonary sarcoidosis. Respir Med 2012; 106: 1351-61.
[6]
Baughman RP, Lower EE, du Bois RM. Sarcoidosis. Lancet 2003; 361: 1111-8.
[7]
Maturu VN, Rayamajhi SJ, Agarwal R, et al. Role of serial F-18 FDG PET/CT scans in assessing treatment response and predicting relapses in patients with symptomatic sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2016; 33: 372-80.
[8]
Teirstein AS, Machac J, Almeida O, et al. Results of 188 whole-body FDG PET scans in 137 patients with sarcoidosis. Chest 2007; 132: 1949-53.
[9]
Altini C, Niccoli AA, Di Palo A, et al. 18F-FDG PET/CT role in staging of gastric carcinomas: Comparison with conventional contrast enhancement computed tomography. Medicine (Baltimore) 2015; 94(20): e864.
[10]
Altini C, Niccoli AA, De Luca R, et al. Comparison of (18)F-FDG PET/CT methods of analysis for predicting response to neoadjuvant chemoradiation therapy in patients with locally advanced low rectal cancer. Abdom Imaging 2015; 40(5): 1190-202.
[11]
Niccoli Asabella A, Ciccone MM, Cortese F, et al. Higher reliability of 18F-FDG target background ratio compared to standardized uptake value in vulnerable carotid plaque detection: A pilot study. Ann Nucl Med 2014; 28: 571-9.
[12]
Rosen Y. Pathology of sarcoidosis. Semin Respir Crit Care Med 2007; 28: 36-52.
[13]
Keijsers RGM, van den Heuvel DAF, Grutters JC. Imaging the inflammatory activity of sarcoidosis. Eur Respir J 2013; 41: 743-51.
[14]
Kaira K, Ishizuka T, Yanagitani N, et al. Value of FDG positron emission tomography in monitoring the effects of therapy in progressive pulmonary sarcoidosis. Clin Nucl Med 2007; 32: 114-6.
[15]
Nguyen BD. F-18 FDG PET imaging of disseminated sarcoidosis. Clin Nucl Med 2007; 32: 53-4.
[16]
Vardhanabhuti V, Venkatanarasimha N, Bhathagar G, et al. Extrapulmonary manifestation of sarcoidosis. Clin Radiol 2012; 67: 263-76.
[17]
Sobic-Saranovic DP, Grozdic IT, Videnovic-Ivanov J, et al. Responsiveness of FDG PET/CT to treatment of patients with active chronic sarcoidosis. Clin Nucl Med 2013; 38(7): 516-21.
[18]
De Prost N, Kerrou K, Sibony M, et al. Fluorine-18 fluorodeoxyglucose with positron emission tomography revealed bonemarrow involvement in sarcoidosis patients with anaemia. Respiration 2010; 79: 25-31.
[19]
Aberg C, Ponzo F, Raphael B, et al. FDG positron emission tomography of bone involvement in sarcoidosis. AJR 2004; 182: 975-7.
[20]
Asabella AN, Gatti P, Notaristefano A, et al. F-18 FDG PET/CT in the diagnosis of a rare case of neurosarcoidosis in a patient with diabetes insipidus. Clin Nucl Med 2011; 36(9): 795-7.
[21]
Rubini G, Cappabianca S, Altini C, et al. Current clinical use of 18FDG-PET/CT in patients with thoracic and systemic sarcoidosis. Radiol Med 2014; 119(1): 64-74.
[22]
Consensus conference. Activity of sarcoidosis. Third WASOG meeting, Los Angeles, USA, September 8-11 1993. Eur Respir J 1994; 7: 624-7.
[23]
Ambrosini V, Zompatori M, Fasano L, et al. 18F-FDG PET/CT for the assessment of disease extension and activity in patients with sarcoidosis. Results of preliminary prospective study. Clin Nucl Med 2013; 38: 171-7.
[24]
Imperiale A, Riehm S, Braun JJ. Interest of [18F] FDG PET/CT for treatment efficacy assessment inaggressive phenotype of sarcoidosis with special emphasis on sinonasal involvement. Q J Nucl Med Mol Imaging 2013; 57(2): 177-86.
[25]
Alavi A, Gupta N, Alberini JL, et al. Positron emission tomography imaging in nonmalignant thoracic disorders. Semin Nucl Med 2002; 32: 293-321.
[26]
Yakar A, Yakar F. Sezar m, et al Use of PET-CT for the assessment of treatment results in patients with sarcoidosis. Wien Klin Wochenschr 2015; 127: 274-82.
[27]
Umeda Y, Demura Y, Morikawa M, et al. Prognostic value of dual-time-point 18F-fluorodeoxyglucose positron emission tomography in patients with pulmonary sarcoidosis. Respirology 2011; 16: 713-20.

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