Hybrid Imaging in Evaluation of Abdominal Sarcoidosis

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.

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Hybrid Imaging in Head and Neck Sarcoidosis

Journal of Clinical Medicine ◽

10.3390/jcm8060803 ◽

2019 ◽

Vol 8 (6) ◽

pp. 803 ◽

Cited By ~ 1

Author(s):

Isidora Grozdic Milojevic ◽

Marijana Tadic ◽

Dragana Sobic-Saranovic ◽

Jelena Saponjski ◽

Vera M. Artiko

Keyword(s):

Head And Neck ◽

Fdg Pet ◽

Therapy Response ◽

Cervical Lymph Nodes ◽

Ct Examination ◽

Pet Ct ◽

Fdg Pet Ct ◽

Radiological Procedures ◽

Active Disease

To determine the prevalence of head and neck sarcoidosis (HNS) and evaluate the role of hybrid molecular imaging in HNS. Between 2010 and 2018, 222 patients with chronic sarcoidosis and presence of prolonged symptoms of active disease were referred to FDG PET/CT. Active disease was found in 169 patients, and they were all screened for the presence of HNS. All patients underwent MDCT and assessment of the serum ACE level. Follow-up FDG PET/CT examination was done 19.84 ± 8.98 months after the baseline. HNS was present in 38 out of 169 patients. FDG uptake was present in: cervical lymph nodes (38/38), submandibular glands (2/38), cerebrum (2/38), and bone (1/38). The majority of patients had more than two locations of disease. After FDG PET/CT examination, therapy was changed in most patients. Fourteen patients returned to follow-up FDG PET/CT examination in order to assess the therapy response. PET/CT revealed active disease in 12 patients and complete remission in two patients. Follow-up ACE levels had no correlation with follow-up SUVmax level (ρ = −0.18, p = 0.77). FDG PET/CT can be useful in the detection of HNS and in the evaluation of the therapy response. It may replace the use of non-purposive mounds of insufficiently informative laboratory and radiological procedures.

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THU0306 ROLE OF 18-FDG PET/CT IN DIAGNOSIS AND FOLLOW UP OF LARGE VESSELS VASCULITIS

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2020-eular.6176 ◽

2020 ◽

Vol 79 (Suppl 1) ◽

pp. 381.1-382

Author(s):

L. Gigante ◽

D. Bruno ◽

V. Feudo ◽

S. L. Bosello ◽

L. Leccisotti ◽

...

Keyword(s):

Fdg Pet ◽

Clinical Remission ◽

Disease Onset ◽

Pet Ct ◽

Left And Right ◽

Fdg Pet Ct ◽

Large Vessels ◽

Active Disease

Background:18-FDG PET/CT is a functional imaging method which allows to identify inflammation of vessel walls. The use of PET in large vessels vasculitis(LVV) at disease onset and during follow up is still debate either to confirm clinical remission either to drive the therapy choice. American Society of Nuclear Cardiology (ASNC) recently advanced recommendations aimed to standardize the application of PET in LVV(1).Objectives:The aim of our study was to assess the clinical role of PET performed in patients affected by LVV at the diagnosis and during the follow up.Methods:We retrospectively evaluated PET/CT of 49 patients affected by clinically active LVV according to LVV visual grading (LVG, grading 0-3) and measured the standardized uptake value(SUV) of large vessels. 38 (77,6%) patients were affected by Giant Cells Arteritis and 11(22,4%) by Takayasu Arteritis. 32(65.3%) patients repeated the imaging after a mean follow-up of 11.5±5.4 months.All baseline (T0) and follow up (T1) clinical data of disease activity were collected. Patients were treated according to EULAR LVV management recommendations(2). T0 PET/CT study was performed in patients with a clinically active disease defined by suggestive symptoms/signs and/or high inflammatory markers. The mean disease duration before T1 PET/CT examination was 4 months. T0 PET was performed in 25/49 patients(52%) at the diagnosis of LVV, whereas in 24/49(48%) patients with already diagnosed but active LVV disease.Results:Baseline PET was positive in 21 patients(42.9%). According to ASNC recommendations, 19 patients (38.8%) presented a LVG=3, 2(4.0%) a LVG=2, 6(12.2%) LVG=1 and 22 (44.9%) LVG=0. Patients performing PET at disease onset(75%) had higher LVG score than patients performing PET during the disease course (25%),p=0,002. At T0, aortic, carotid, axillary and subclavian SUV did not correlate with inflammatory markers.Follow up PET/CT studies were performed in 32 patients, 13 (40.6%) with a clinically active disease despite therapy, while 19(59.4%) in clinical remission.Follow up PET was still positive in 8 patients (25%) with a LVG=3, 10 (31.2%) patients presented LVG=1 and 14 (43.8%) LVG=0. T1 PET/CT study showed a significant reduction of SUV values in descending aorta, left and right subclavian arteries, and left and right axillary arteries when compared with first PET/CT study. According to LVG, 12 patients with active PET/CT study at T0 (19 pts) presented a reduction of LVG from score 2 and 3 to grade 1 or 0 (64.2%) at second PET/CT study. Only 3 patients presented an increased LVG score at T1, while in the other 17 patients T1 PET confirmed the previous score. No significant difference was found between LVG scores according with clinical characteristics, but among 8 patients presenting an active T1 PET, 4(50%) were in clinical remission.Conclusion:The use of ASNC recommendations for FDG PET/CT in LVV enables to confirm a metabolically active disease in 40% of patients and in 75% of patients at disease onset, suggesting that post-posing the exam could lead to underrate the real extension of disease. Our data, even if limited, suggest that PET/CT could be crucial in management of patients in clinical remission, detecting patients with still metabolically active LVV. Further prospective studies are necessary to evaluate the role of PET/CT in driving therapeutic strategies.References:[1]Slart R et all - Eur J Nucl Med Mol Imaging, 2018[2]Hellmich et all – Ann Rheum Dis 2018Disclosure of Interests:Laura Gigante: None declared, Dario Bruno: None declared, Vanessa Feudo: None declared, Silvia Laura Bosello Speakers bureau: Abbvie, Pfizer, Boehringer, Lucia Leccisotti: None declared, Alessia Musto: None declared, Pier Giacomo Cerasuolo: None declared, Angelo Zoli: None declared, Alessandro Giordano: None declared, Elisa Gremese Speakers bureau: Abbvie, BMS, Celgene, Jannsen, Lilly, MSD, Novartis, Pfizer, Sandoz, UCB

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The Role of 18F-FDG PET/CT in Follow up After Treatment in Childhood Langerhans Cell Histiocytosis.

The Egyptian Journal Nuclear Medicine ◽

10.21608/egyjnm.2019.106661 ◽

2019 ◽

Vol 19 (2) ◽

pp. 50-63

Author(s):

Ismail, A ◽

Abdel Gaid, S.

Keyword(s):

Fdg Pet ◽

Langerhans Cell Histiocytosis ◽

Langerhans Cell ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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323P The role of SUVmax in 18F-FDG PET/CT for assessing radiation therapy response for cervical cancer

Annals of Oncology ◽

10.1093/annonc/mdw585.027 ◽

2016 ◽

Vol 27 (suppl_9) ◽

Author(s):

S.H. Lee ◽

K.C. Lee ◽

K. Sung ◽

E.Y. Choi ◽

J.B. Bae ◽

...

Keyword(s):

Cervical Cancer ◽

Radiation Therapy ◽

Fdg Pet ◽

Therapy Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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Potential role of [18F]FDG-PET/CT in the evaluation of therapy response after neoadjuvant chemotherapy

European Journal of Cancer Supplements ◽

10.1016/s1359-6349(06)80400-3 ◽

2006 ◽

Vol 4 (2) ◽

pp. 159

Author(s):

I. Segaert ◽

Neven ◽

S. Stroobants ◽

M. Drijkoningen ◽

F. Amant ◽

...

Keyword(s):

Neoadjuvant Chemotherapy ◽

Fdg Pet ◽

Potential Role ◽

Therapy Response ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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FRI0262 The Role of 18F-FDG-PET/CT in the Diagnosis and Follow-Up of Large Vessel Vasculitis

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2015-eular.4237 ◽

2015 ◽

Vol 74 (Suppl 2) ◽

pp. 519.2-519

Author(s):

G. Pazzola ◽

M. Casali ◽

F. Muratore ◽

N. Pipitone ◽

L. Boiardi ◽

...

Keyword(s):

Fdg Pet ◽

Large Vessel Vasculitis ◽

Large Vessel ◽

Pet Ct ◽

18F Fdg ◽

Fdg Pet Ct

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The Role of Staging Evaluation at Initial Diagnosis of Adult Patients with Clinically Isolated Pulmonary Langerhans Cell Histiocytosis

Blood ◽

10.1182/blood-2020-136861 ◽

2020 ◽

Vol 136 (Supplement 1) ◽

pp. 45-45

Author(s):

Antonious Hazim ◽

Gordon Ruan ◽

Aishwarya Ravindran ◽

Jithma P. Abeykoon ◽

Caleb J Scheckel ◽

...

Keyword(s):

Pulmonary Disease ◽

Fdg Pet ◽

Braf V600e ◽

Imaging Studies ◽

Pet Ct ◽

Extra Pulmonary ◽

Fdg Pet Ct ◽

Histopathologic Findings

Background: Langerhans cell histiocytosis (LCH) is the most common histiocytic disorder that is now recognized as a neoplasm by the World Health Organization. It is generally classified based on the site and extent of disease involvement (single system or multisystem). Pulmonary LCH (pLCH), an uncommon interstitial lung disease associated with smoking, often presents as isolated pulmonary disease. It is unclear whether patients with clinically isolated pLCH have extra-pulmonary lesions at diagnosis or during the course of their disease. The role of [18F] fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET-CT) in the staging of pLCH remains unclear. Our study aims to better characterize the utility of radiographic staging studies at time of diagnosis and prevalence of extrapulmonary disease at follow up in pLCH. Methods: We conducted a retrospective study of patients presenting with clinical findings consistent with isolated pLCH seen at the Mayo Clinic from January 2000 to January 2020. All patients had a diagnosis of pLCH determined by chest imaging studies [computed tomography (CT) or high-resolution CT (HRCT)] or by histopathologic findings from surgical or transbronchial lung biopsy. Histopathologic findings for the diagnosis of pLCH required the presence of Langerhans cells (S100+/CD1a+/Langerin+). Patients were excluded if they had clinically apparent extra-pulmonary organ involvement at the time of diagnosis. BRAF V600E mutation was determined by immunohistochemistry (IHC) or cell-free DNA (cfDNA). Staging was defined as FDG-PET-CT or whole body CT imaging obtained within 3 months of diagnosis of pLCH. Extra-pulmonary LCH involvement was determined by imaging characteristics or by histopathologic findings. Descriptive statistics and overall survival (OS) were analyzed with JMP software, version 14 (SAS Institute Inc., Cary, NC). Results: A total of 112 patients with clinically isolated pLCH were identified. The median age at diagnosis was 45 years (range 21-73), and 48 (43%) were male. The majority (n=110, 99%) were former or current smokers with a median pack year of 25 (range 1-57). Three (3%) patients were noted to have occupational industrial exposure. Nine patients had a history of another cancer prior to their diagnosis and staging of pLCH [lung (n=4), breast (n=2), neuroendocrine (n=2), thyroid (n=1)]. Presenting symptoms included dyspnea on exertion 49 (44%), cough 18 (16%), chest pain 14 (13%), and 29 (28%) were incidentally discovered on imaging studies. On HRCT, the following characteristics were observed: 42 (38%) cystic, 32 (29%) cystic and nodular, 37 (33%) nodular, 1 (<1%) ground glass opacities. Seventy (63%) patients had lung biopsy confirmation, of which 11 (16%) patients underwent BRAF V600Emutation testing (7 by IHC, 4 by cfDNA). Six (55%) of these 11 patients were positive for BRAF V600E mutation. 34 (30%) patients underwent radiographic staging studies within 3 months of diagnosis of pLCH (25 FDG-PET-CT and 9 whole-body CT), and none of these imaging studies showed evidence of extra-pulmonary disease. Of the patients who had at least one year of follow-up (n=52), one (2%) developed extra-pulmonary disease. This patient did not undergo initial staging studies, developed headaches and was found to have a large calvarial lytic lesion within 2 months of pLCH diagnosis (BRAF V600E+). Among those who did not undergo staging at diagnosis (n=78), long term (>5 years) follow up data were available for 23 (29%), and none developed extra-pulmonary disease as determined by clinical notes or imaging studies. No patient had evidence of new extra-pulmonary involvement or second malignancy at the time of last known follow-up. After a median follow-up duration of 2.4 years (95% CI: 1.5-3.6, range: 0.1-17) ten (9%) patients died, of which 5 died of pLCH related complications. The median OS for entire cohort was 15 years (95% CI 9.1-not reached, Figure 1). Conclusion: Our study shows that adult patients with clinically isolated pLCH rarely present with extra-pulmonary manifestations at diagnosis or at follow up. These findings suggest a limited role of routine radiographic staging studies in pLCH unless clinically indicated. Studies on longer follow up of this cohort would provide further insights into the natural history of pLCH and are underway. Disclosures Bennani: Purdue Pharma: Other: Advisory Board; Verastem: Other: Advisory Board; Kite/Gilead: Research Funding; Affimed: Research Funding. Shah:Dren Bio: Consultancy.

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