ORIGINAL ARTICLES   

The Quarterly Journal of Nuclear Medicine and Molecular imaging 2011 February;55(1):66-71

Copyright © 2011 EDIZIONI MINERVA MEDICA

lingua: Inglese

Imaging the inflammatory activity of sarcoidosis: sensitivity and inter observer agreement of 67Ga imaging and 18F-FDG PET

Keijsers R. G. ¹, Grutters J. C. ², Thomeer M. ³, Du Bois R. M. ⁴, Van Buul M. M. ¹, Lavalaye J. ¹, Van Den Bosch J. M. ², Verzijlbergen F. J. ¹ ✉

¹ Department of Nuclear Medicine, St Antonius Hospital, Nieuwegein, the Netherlands; ² Department of Pulmonology, St Antonius Hospital, Nieuwegein, the Netherlands; ³ Department of Pulmonology, Universitaire Ziekenhuizen Leuven, Ziekenhuis Oost-Limburg, Belgium; ⁴ Pulmonary and Occupational and Environmental Health Divisions, National Jewish Health, Denver, CO, USA

AIM: The aim of this study was to investigate sensitivity of 67Ga imaging and 18F-FDG PET for sarcoidosis activity and their inter observer variability.
METHODS: Thirty-four newly diagnosed, histologically proven sarcoidosis patients were analyzed prospectively. 67Ga imaging and 18F-FDG PET were performed, the presence of pulmonary and extra pulmonary lesions was evaluated and inter observer variability of both techniques was assessed.
RESULTS: Overall sensitivity to detect active sarcoidosis was 88% for 67Ga imaging and 97% for 18F-FDG PET. Although these results were not significantly different, 18F-FDG PET detected more lesions in the mediastinum (P<0.05), hila (P<0.05), lymph nodes (P<0.001) and extra pulmonary regions in general (P<0.001). Inter observer agreement was poor to moderate for 67Ga imaging (kappa 0.19-0.59) and good to very good for 18F-FDG PET (kappa 0.65-1.00).
CONCLUSION: 18F-FDG PET is more sensitive than 67Ga imaging in the assessment of sarcoidosis activity with regard to the mediastinum, hila, lymph nodes and extra pulmonary lesions in general.
Furthermore, 18F-FDG PET demonstrates a very good inter observer agreement in contrast with 67Ga imaging and 18F-FDG PET is therefore the nuclear imaging technique of choice in sarcoidosis assessment.