What is the role of FDG-PET in the workup of neurosarcoidosis?

Updated: Nov 13, 2018
  • Author: Gabriel Bucurescu, MD, MS; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Answer

Fluorodeoxyglucose positron emission tomography (FDG-PET) imaging may show areas of hypermetabolism or hypometabolism in the central nervous system, and this information may be compared to a systemic PET scan in patients with systemic sarcoidosis, thus establishing a firmer diagnosis. However, because the brain has high metabolic activity, it may be difficult to interpret PET imaging in the evaluation of neurosarcoidosis. Whole-body FDG-PET was fojnd to be more sensitive than gallium scanning for assessing activity of sarcoidosis. [27] It has proven of great value in detecting occult diagnostic biopsy sites and in assessing residual activity in fibrotic pulmonary sarcoidosis and may help in making therapeutic decisions.

Whole-body FDG-PET scanning may reveal otherwise occult/subclinical areas of involvement, demonstrate the extent of disease, and suggest possible biopsy sites.

The combination of FDG- and F-18 fluorothymidine (FLT) PET/CT scanning can help in differentiating neurosarcoidosis from malignancy and in localizing biopsy sites. [28]


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