Imaging the inflammatory activity of sarcoidosis: sensitivity and inter observer agreement of (67)Ga imaging and (18)F-FDG PET.
OBJECTIVE
The aim of this study was to investigate sensitivity of 67Ga imaging and 18F-FDG PET for sarcoidosis activity and their inter observer variability.


METHODS
Thirty-four newly diagnosed, histologically proven sarcoidosis patients were analyzed prospectively. (67)Ga imaging and (18)F-FDG PET were performed, the presence of pulmonary and extra pulmonary lesions was evaluated and inter observer variability of both techniques was assessed.


RESULTS
Overall sensitivity to detect active sarcoidosis was 88% for (67)Ga imaging and 97% for (18)F-FDG PET. Although these results were not significantly different, 18F-FDG PET detected more lesions in the mediastinum (P<0.05), hila (P<0.05), lymph nodes (P<0.001) and extra pulmonary regions in general (P<0.001). Inter observer agreement was poor to moderate for (67)Ga imaging (kappa 0.19-0.59) and good to very good for (18)F-FDG PET (kappa 0.65-1.00).


CONCLUSIONS
(18)F-FDG PET is more sensitive than (67)Ga imaging in the assessment of sarcoidosis activity with regard to the mediastinum, hila, lymph nodes and extra pulmonary lesions in general. Furthermore, (18)F-FDG PET demonstrates a very good inter observer agreement in contrast with (67)Ga imaging and (18)F-FDG PET is therefore the nuclear imaging technique of choice in sarcoidosis assessment.
Department of Nuclear Medicine, St Antonius Hospital, Nieuwegein, the Netherlands. r.keijsers@antoniusziekenhuis.nl
R G
RG
Keijsers
J C
JC
Grutters
M
M
Thomeer
R M
RM
Du Bois
M M
MM
Van Buul
J
J
Lavalaye
J M
JM
Van Den Bosch
F J
FJ
Verzijlbergen
D000328:Adult; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005710:Gallium Radioisotopes; D006801:Humans; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data; D011446:Prospective Studies; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000000981:diagnostic imaging*; D017565:Sarcoidosis, Pulmonary / Q000000981:diagnostic imaging*; D012680:Sensitivity and Specificity
D005462:Fluorine Radioisotopes; D005710:Gallium Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18