Use of 18F-FDG PET in assessing response to treatment in adults with pulmonary sarcoidosis: A systematic literature review
Keywords:
FDG PET, 18F-fluorodeoxyglucose positron emission computed tomography (18F-FDG-PET CT), PET-CT, sarcoidosis, autoimmune diseaseAbstract
Background and aim: Symptoms, severity and response to treatment of sarcoidosis can follow a heterogenous pattern, presenting a clinical challenge. Use of Fludeoxyglucose F18 Positron Emission Tomography (18F-FDG PET) in disease monitoring remains uncertain. We undertook a systematic literature review on the use of 18F-FDG PET in assessing response to treatment in adults with pulmonary sarcoidosis.
Methods: Articles discussing 18F-FDG PET use in response to treatment in pulmonary sarcoidosis published until January 2024 were included. All article types were eligible except opinion pieces, case reports, case series of ≤10 patients and reviews.
Results: Time between baseline 18F-FDG PET and follow-up scan ranged from 2 to 6 months. Compared to clinical response, sensitivity of 18F-FDG PET in determining response to treatment ranged from 56% to 100%, with mean sensitivity of 75.3% (SD 16.0).
Conclusions: 18F-FDG PET could be considered in monitoring response to immunosuppression in patients with pulmonary sarcoidosis.
References
1. Rossi G, Cavazza A, Colby TV. Pathology of sarcoidosis. Clin Rev Allergy Immunol 2015;49:36‑44. doi: 10.1007/s12016‑015‑8479‑6
2. Ungprasert P, Ryu JH, Matteson EL. Clinical manifestations, diagnosis, and treatment of sarcoidosis. Mayo Clin Proc Innov Qual Outcomes 2019;3:358. doi: 10.1016/j.mayocpiqo.2019.04.006
3. Society ER. Consensus conference: activity of sarcoidosis. Third WASOG meeting, Los Angeles, USA, September 8‑11, 1993. Eur Respir J 1994;7:624‑7. doi: 10.1183/09031936.94.07030624
4. Keijsers RGM, Grutters JC. In which patients with sarcoidosis is FDG PET/CT indicated? J Clin Med 2020;9:890. doi: 10.3390/jcm9030890
5. Farwell MD, Pryma DA, Mankoff DA. PET/CT imaging in cancer: current applications and future directions. Cancer 2014;120:3433‑45. doi: 10.1002/cncr.28860
6. Warburg O. The metabolism of tumours. Constable and Company 1930
7. Koiwa H, Tsujino I, Ohira H, et al. Images in cardiovascular medicine: imaging of cardiac sarcoid lesions using fasting cardiac 18F‑fluorodeoxyglucose positron emission tomography: an autopsy case. Circulation 2010;122:535‑6. doi: 10.1161/CIRCULATIONAHA.110.952184
8. EACVI Reviewers, et al. A joint procedural position statement on imaging in cardiac sarcoidosis: from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine, the European Association of Cardiovascular Imaging, and the American Society of Nuclear Cardiology. Eur Heart J Cardiovasc Imaging 2017;18:1073‑89. doi: 10.1093/ehjci/jex146
9. Régis C, Benali K, Rouzet F. FDG PET/CT imaging of sarcoidosis. Semin Nucl Med 2023;53:258‑72. doi: 10.1053/j.semnuclmed.2022.08.004
10. Statement on sarcoidosis. Am J Respir Crit Care Med 1999;160:736‑55. doi: 10.1164/ajrccm.160.2.ats4‑99
11. Diagnosis and detection of sarcoidosis. Am J Respir Crit Care Med (ATS guideline) [year n.d.];[volume n.d.]:[pages n.d.] – ATS guideline title only, DOI given in URL; DOI removed per rules.
12. Nagai S, Handa T, Ito Y, et al. Outcome of sarcoidosis. Clin Chest Med 2008;29:565‑74. doi: 10.1016/j.ccm.2008.03.006
13. Cochrane Handbook for Systematic Reviews of Interventions. [anno n.d.];[vol n.d.]:[pp n.d.]
14. Page MJ, Moher D, Bossuyt PM, et al. PRISMA 2020 explanation and elaboration: updated guidance and exemplars for reporting systematic reviews. BMJ 2021;372:n160. doi: 10.1136/bmj.n160
15. PROSPERO: International prospective register of systematic reviews: what are the PET imaging use in prognosis, response to treatment and outcomes of pulmonary sarcoidosis? [anno n.d.];[vol n.d.]:[pp n.d.] – titolo riportato, ma senza formato standard.
16. Shea BJ, Reeves BC, Wells G, et al. AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non‑randomised studies of healthcare interventions, or both. BMJ 2017;358:j4008. doi: 10.1136/bmj.j4008
17. Cochrane Controlled Register of Trials (CENTRAL). [anno n.d.];[vol n.d.]:[pp n.d.]
18. Wells G, Shea B, O’Connell D, et al. The Newcastle‑Ottawa Scale (NOS) for Assessing the Quality of Non‑Randomized Studies in Meta‑Analysis. 2000
19. 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;35:1537‑43. doi: 10.1007/s00259‑008‑0770‑9
20. Chen H, Jin R, Wang Y, et al. The utility of 18F‑FDG PET/CT for monitoring response and predicting prognosis after glucocorticoids therapy for sarcoidosis. Biomed Res Int 2018;2018:1823710. doi: 10.1155/2018/1823710
21. Keijsers RGM, Verzijlbergen JF, van Diepen DM, et al. 18F‑FDG PET in sarcoidosis: an observational study in 12 patients treated with infliximab. Sarcoidosis Vasc Diffuse Lung Dis 2008;25:143‑9
22. Guleria R, Jyothidasan A, Madan K, et al. Utility of FDG‑PET‑CT scanning in assessing the extent of disease activity and response to treatment in sarcoidosis. Lung India 2014;31:323‑30. doi: 10.4103/0970‑2113.142092
23. 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
24. 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;38:516‑21. doi: 10.1097/RLU.0b013e31828731f5
25. Mostard RLM, Vöö S, van Kroonenburgh MJPG, et al. Inflammatory activity assessment by F18 FDG‑PET/CT in persistent symptomatic sarcoidosis. Respir Med 2011;105:1917‑24. doi: 10.1016/j.rmed.2011.08.012
26. Mostard RL, Kuijk SMV, Verschakelen JA, et al. A predictive tool for an effective use of 18F‑FDG PET in assessing activity of sarcoidosis. BMC Pulm Med 2012;12:57. doi: 10.1186/1471‑2466‑12‑57
27. Mostard RLM, Verschakelen JA, van Kroonenburgh MJPG, et al. Severity of pulmonary involvement and (18)F‑FDG PET activity in sarcoidosis. Respir Med 2013;107:439‑47. doi: 10.1016/j.rmed.2012.11.011
28. Treglia G, Annunziata S, Sobic‑Saranovic D, et al. The role of 18F‑FDG‑PET and PET/CT in patients with sarcoidosis: an updated evidence‑based review. Acad Radiol 2014;21:675‑84. doi: 10.1016/j.acra.2014.01.008
29. Treglia G, Cason E, Fagioli G. Recent applications of nuclear medicine in diagnostics (I part). Ital J Med 2010;4:84‑91. doi: 10.4081/itjm.2010.84
30. Treglia G, Cason E, Fagioli G. Recent applications of nuclear medicine in diagnostics: II part. Ital J Med 2010;4:159‑66. doi: 10.4081/itjm.2010.159
31. Sobic‑Saranovic D, Artiko V, Obradovic V. FDG PET imaging in sarcoidosis. Semin Nucl Med 2013;43:404‑11. doi: 10.1053/j.semnuclmed.2013.06.007
32. Adams H, van Rooij R, van Moorsel CHM, et al. Volumetric FDG PET analysis of global lung inflammation: new tool for precision medicine in pulmonary sarcoidosis? Sarcoidosis Vasc Diffuse Lung Dis 2018;35:44‑54. doi: 10.36141/svdld.v35i1.5807
33. Teirstein AS, Machac J, Almeida O, et al. Results of 188 whole‑body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. Chest 2007;132:1949‑53. doi: 10.1378/chest.07‑1178
34. Keijsers RG, Verzijlbergen FJ, Oyen WJ, et al. 18F‑FDG PET, genotype‑corrected ACE and sIL‑2R in newly diagnosed sarcoidosis. Eur J Nucl Med Mol Imaging 2009;36:1131‑7. doi: 10.1007/s00259‑009‑1097‑x
35. Ramos‑Casals M, Retamozo S, Sisó‑Almirall A, et al. Clinically‑useful serum biomarkers for diagnosis and prognosis of sarcoidosis. Expert Rev Clin Immunol 2019;15:391‑405. doi: 10.1080/1744666X.2019.1568240
36. Kraaijvanger R, Janssen Bonás M, Vorselaars ADM, et al. Biomarkers in the diagnosis and prognosis of sarcoidosis: current use and future prospects. Front Immunol 2020;11:1443. doi: 10.3389/fimmu.2020.01443
37. Adams H, Keijsers RG, Korenromp IHE, et al. FDG PET for gauging of sarcoid disease activity. Semin Respir Crit Care Med 2014;35:352‑61. doi: 10.1055/s‑0034‑1376866
38. Keijsers RG, Verzijlbergen EJ, van den Bosch JM, et al. 18F‑FDG PET as a predictor of pulmonary function in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2011;28:123‑9
39. Schimmelpennink MC, Vorselaars ADM, Veltkamp M, et al. Quantification of pulmonary disease activity in sarcoidosis measured with 18F‑FDG PET/CT: SUVmax versus total lung glycolysis. EJNMMI Res 2019;9:54. doi: 10.1186/s13550‑019‑0505‑x
40. 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 a preliminary prospective study. Clin Nucl Med 2013;38:e171‑7. doi: 10.1097/RLU.0b013e31827a27df
41. 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;53:1543‑9. doi: 10.2967/jnumed.112.104380
42. Judson MA. Advances in the diagnosis and treatment of sarcoidosis. F1000Prime Rep 2014;6:89. doi: 10.12703/P6‑89
43. Tana C, Drent M, Nunes H, et al. Comorbidities of sarcoidosis. Ann Med 2022;54:1014‑35. doi: 10.1080/07853890.2022.2063375
44. Asif H, Ribeiro Neto ML, Culver DA. Pulmonary fibrosis in sarcoidosis. Sarcoidosis Vasc Diffuse Lung Dis 2023;40:e2023027. doi: 10.36141/svdld.v40i3.14830
45. Tana C, Mantini C, Donatiello I, et al. Clinical features and diagnosis of cardiac sarcoidosis. J Clin Med 2021;10:1941. doi: 10.3390/jcm10091941
46. Al Hayja MA, Vinjamuri S. Cardiac sarcoidosis: the role of cardiac MRI and 18F‑FDG‑PET/CT in the diagnosis and treatment follow‑up. Br J Cardiol 2023;30:7. doi: 10.5837/bjc.2023.007
47. Kim SJ, Pak K, Kim K. Diagnostic performance of F‑18 FDG PET for detection of cardiac sarcoidosis; a systematic review and meta‑analysis. J Nucl Cardiol 2020;27:2103‑15. doi: 10.1007/s12350‑018‑01582‑y
48. Furuya S, Manabe O, Ohira H, et al. Which is the proper reference tissue for measuring the change in FDG PET metabolic volume of cardiac sarcoidosis before and after steroid therapy? EJNMMI Res 2018;8:94. doi: 10.1186/s13550‑018‑0447‑8
49. Ramirez R, Trivieri M, Fayad ZA, et al. Advanced imaging in cardiac sarcoidosis. J Nucl Med 2019;60:892‑8. doi: 10.2967/jnumed.119.228130
50. Hena KM. Sarcoidosis epidemiology: race matters. Front Immunol 2020;11:537382. doi: 10.3389/fimmu.2020.537382
51. Gallach M, Lette MM, Abdel‑Wahab M, et al. Addressing global inequities in positron emission tomography‑computed tomography (PET‑CT) for cancer management: a statistical model to guide strategic planning. Med Sci Monit 2020;26:e926544‑1‑e926544‑8. doi: 10.12659/MSM.926544
52. African diaspora. Encyclopedia.com. Available from: https://www.encyclopedia.com/social-sciences-and-law/anthropology-and-archaeology/human-evolution/african-diaspora [accessed 2024 Aug 19].
Downloads
How to Cite
Issue
Section
License
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Transfer of Copyright and Permission to Reproduce Parts of Published Papers.
Authors retain the copyright for their published work. No formal permission will be required to reproduce parts (tables or illustrations) of published papers, provided the source is quoted appropriately and reproduction has no commercial intent. Reproductions with commercial intent will require written permission and payment of royalties.
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
