Chest
Original ResearchChest ImagingDiagnostic Usefulness of Fluorine–18-α–Methyltyrosine Positron Emission Tomography in Combination With 18F-Fluorodeoxyglucose in Sarcoidosis Patients
Section snippets
Sarcoidosis:
Eligible patients were required to have histologically proven noncaseating epithelioid cell granuloma and at least one disease such that the possibility of coexistent malignancy could not be excluded, as follows: (1) extrapulmonary lesions mimicking malignant diseases including systemic lymphadenopathy, hepatosplenic involvement, or other lesions; (2) multiple nodular lesions mimicking pulmonary metastasis; and (3) the occurrence of BHL in a cancer patient. PET imaging using 18F-FDG and 18F-FMT
Control Group of Patients With Lung Cancer
Patient characteristics and results of PET findings are listed in Table 1. Of the 17 patients (13 men and 4 women; mean age, 61 years; range, 45 to 82 years), 9 patient had adenocarcinoma, 6 patients had squamous cell carcinoma, and 2 patients had NSCLC. PET imaging of 18F-FDG and 18F-FMT is shown in Figure 1.
Discussion
In the present study, 18F-FMT PET was useful for the evaluation of sarcoidosis in patients who were suspected of having malignant neoplasm. Since the uptake of 18F-FDG is nonspecific for malignant tumor, systemic disease of sarcoidosis is likely to mislead the diagnosis of metastatic disease. In all cases, coexistent malignancy could be clinically excluded in the study. The fact that one primary tumor and one metastatic lymph node were 18F-FDG positive but 18F-FMT negative highlights the
Conclusion
The present study found that the sarcoid lesions were positive on 18F-FDG PET and were negative on 18F-FMT PET in sarcoidosis patients. 18F-FMT PET may not replace 18F-FDG PET in the diagnosis of malignant lesions but may be a useful tool in combination with 18F-FDG PET in the diagnosis of sarcoidosis in patients with clinical suspicion of cancer or in characterizing individual lesions in patients with coexisting cancer and sarcoidosis. Further investigation is required to verify these results.
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Our clinical trial registration number is ClinicalTrials.gov ID: NCT00369980.
The authors have no conflicts of interest to disclose.