Objective: To determine the prevalence of abdominal involvement, distribution pattern
and evaluate role of hybrid molecular imaging in patients with abdominal sarcoidosis.
Methods:
Between January 2010 and December 2011, 98 patients with chronic sarcoidosis and
presence of prolonged symptoms or other findings suggestive of active disease were referred to
FDG PET/CT examination. Active disease was found in 82 patients, and they all were screened for
the presence of abdominal sarcoidosis on FDG PET/CT. All patients also underwent MDCT and
assessment of serum ACE level. Follow up FDG PET/CT examination was done 12.3±5.4 months
after the baseline.
Results:
Abdominal sarcoidosis was present in 31/82 patients with active sarcoidosis. FDG uptake
was present in: retroperitoneal lymph nodes (77%), liver (26%), spleen (23%), adrenal gland (3%).
Majority of patients had more than two locations of disease. Usually thoracic disease was spread
into the extrathoracic localizations, while isolated abdominal sarcoidosis was present in 10% of patients.
After first FDG PET/CT examination therapy was changed in all patients. Eleven patients
came to the follow up examination where SUVmax significantly decreased in the majority of them.
Three patients had total remission, three had absence of abdominal disease but discrete findings in
thorax and others had less spread disease. ACE levels did not correlate with SUVmax level.
Conclusion:
FDG PET/CT can be a useful tool for detection of abdominal sarcoidosis and in the
evaluation of therapy response in these patients. Awareness of the presence of intra-abdominal sarcoidosis
is important in order to prevent long-standing unrecognized disease.
FDG-PET/CT for the Management of Post-Chemotherapy Residual Mass in Hodgkin lymphoma