Tc-99m sestamibi before and during treatment in a patient with sarcoidosis and persistent hyperparathyroidism.
OBJECTIVE
Tc-99m sestamibi (MIBI) uptake in pulmonary sarcoidosis has been reported, but it has never been studied before and during treatment with glucocorticoids.


METHODS
The authors performed MIBI scintigraphy and somatostatin receptor scintigraphy in a patient with sarcoidosis of the mediastinum, lungs, and liver and who had persistent hyperparathyroidism after unsuccessful neck exploration.


RESULTS
Somatostatin receptor scintigraphy showed high mediastinal and pulmonary uptake in a pattern characteristic of sarcoidosis. Sustained MIBI uptake occurred in the same, although smaller, region. After the diagnosis was confirmed by liver biopsy, the patient was treated with glucocorticoids. Repeated MIBI scintigraphy showed that the uptake in the mediastinum had clearly decreased.


CONCLUSIONS
This decrease of MIBI uptake in the mediastinal lymph nodes with therapy may imply that MIBI can be used to assess the response to treatment in sarcoidosis. Perhaps a relation exists between MIBI uptake at the moment of diagnosis and prognosis. Further studies in more patients are needed to evaluate the role of MIBI in the management of sarcoidosis.
Fröberg
A C
AC
Department of Nuclear Medicine, University Hospital Rotterdam, The Netherlands. froberg@nuge.azr.nl
De Herder
W W
WW
Jaap Bonjer
H
H
Krenning
E P
EP
Yoe Oei
H
H
Kwekkeboom
D J
DJ
D003937:Diagnosis, Differential; D005938:Glucocorticoids / Q000627:therapeutic use*; D006801:Humans; D006934:Hypercalcemia / Q000000981:diagnostic imaging / Q000188:drug therapy; D006961:Hyperparathyroidism / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008099:Liver / Q000000981:diagnostic imaging; D008168:Lung / Q000000981:diagnostic imaging; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008482:Mediastinum / Q000000981:diagnostic imaging; D017481:Receptors, Somatostatin / Q000032:analysis; D012507:Sarcoidosis / Q000000981:diagnostic imaging* / Q000188:drug therapy; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging* / Q000188:drug therapy; D015899:Tomography, Emission-Computed, Single-Photon
D005938:Glucocorticoids; D017481:Receptors, Somatostatin