title: F-18 FDG PET/CT for detecting bone and bone marrow involvement in sarcoidosis patients.
abstract: BACKGROUND
  The prevalence of bone involvement in sarcoidosis has been estimated to be 3% to 5%, mostly affecting the phalanges. The aim of this study was to assess the prevalence and distribution pattern of bone and bone marrow involvement as detected by positron emission tomography/computed tomography (PET/CT) in sarcoidosis patients.
  
  
  METHODS
  Between June 2006 and September 2010, 122 patients suffering from severe sarcoidosis who underwent a PET/CT and met the inclusion criteria were studied. In 94 (77%) patients, the PET/CT demonstrated positive findings associated with sarcoidosis. The 94 PET/CTs were screened for the presence of bone/bone marrow localizations. Additionally, low-dose CT scans were screened for other causes of increased bone uptake. Relevant clinical data were gathered retrospectively.
  
  
  RESULTS
  Evidence for bone/bone marrow localizations was found in 34% of the 94 patients with PET/CT-positive findings. Of these patients, 60% showed obvious focal bone lesions at various localizations: axial skeleton (47%), pelvis (40%), extremities (34%), and skull (2%). In 40% of patients, diffuse increased uptake in both axial and peripheral bone marrow, without focal lesions, was found. Both diffuse and focal uptake were seen in 34%, whereas only focal lesions were observed in 25%. In all but 2 (6%) patients, no bone abnormalities on low-dose CT were found.
  
  
  CONCLUSIONS
  More than one-third of PET/CT-positive sarcoidosis patients had osseous abnormalities on PET/CT. The majority of these lesions (94%) could not be detected on low-dose CT. No single localization of preference was found. These preliminary results stress the value of PET/CT imaging in the assessment of bone/bone marrow involvement in sarcoidosis patients.
authors.affiliation: Department of Respiratory Medicine, Atrium Medical Centre, Heerlen, The Netherlands.
authors.forename: Rémy L
authors.initials: RL
authors.lastname: Mostard
authors.forename: Léonne
authors.initials: L
authors.lastname: Prompers
authors.forename: Rene E
authors.initials: RE
authors.lastname: Weijers
authors.forename: Marinus J
authors.initials: MJ
authors.lastname: van Kroonenburgh
authors.forename: Petal A
authors.initials: PA
authors.lastname: Wijnen
authors.forename: Piet P
authors.initials: PP
authors.lastname: Geusens
authors.forename: Marjolein
authors.initials: M
authors.lastname: Drent
mesh_terms: D000328:Adult; D000368:Aged; D001855:Bone Marrow Diseases / Q000175:diagnosis* / Q000453:epidemiology; D015897:Comorbidity; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010000:Osteitis / Q000175:diagnosis* / Q000453:epidemiology; D049268:Positron-Emission Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D019275:Radiopharmaceuticals; D012507:Sarcoidosis / Q000175:diagnosis* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18