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Erschienen in: Wiener klinische Wochenschrift 7-8/2015

01.04.2015 | original article

Use of PET-CT for the assessment of treatment results in patients with sarcoidosis

verfasst von: MD Aysun Yakar, MD Fatih Yakar, MD Murat Sezer, MD Mehmet Bayram, MD Ezgi Başak Erdoğan, MD Didem Özkan, MD Hatice K. Özçelik, MD Prof. Dr. Levent Tabak

Erschienen in: Wiener klinische Wochenschrift | Ausgabe 7-8/2015

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Summary

Background and aim

Sarcoidosis is a multisystem disease of unknown origin. Determining the involvement and the response to the treatment is important. The aim of this study was to identify the effects of methylprednisolone and indomethacine on metabolic activity and pulmonary function test parameters in patients with sarcoidosis.

Material and methods

A total of 24 pulmonary sarcoidosis patients were enrolled in the study. All the patients underwent spirometry and [18F]fluorodeoxyglucose positron emission tomography–computed tomography (FDG PET-CT) scan before treatment and were divided into two groups according to the necessity of corticosteroid treatment or not. Patients who did not have corticosteroid indication were treated with indomethacine. Symptomatic patients and patients who did not respond to indomethacine treatment received methylprednisolone. Patients were followed up on a monthly basis to determine the response. FDG uptakes as the disease activity were re-evaluated before ending the treatment at the sixth month.

Results

Mean age of patients (16 male, 8 female) was 39.79 (9.3) years. Besides mediastinum and pulmonary parenchyma, extrapulmonary sites were also involved in patients with pulmonary sarcoidosis (distant lymph nodes (upper abdominal, supraclavicular, inguinal, and axillary), liver, and spleen). Although maximum standard uptake values of methylprednisolone group regressed significantly (p < 0.001) after treatment, indomethacine group did not have significant regression (p = 0.345). Despite metabolic regressions, spirometry values of patients did not significantly increase (p > 0.005).

Conclusion

FDG PET-CT may be useful for determining activity and the efficacy of treatments. Methylprednisolone is effective in reducing metabolic activity but does not lead to improvement in functional parameters.
Literatur
1.
Zurück zum Zitat Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999;160(2):736–55. Statement on sarcoidosis. Joint Statement of the American Thoracic Society (ATS), the European Respiratory Society (ERS) and the World Association of Sarcoidosis and Other Granulomatous Disorders (WASOG) adopted by the ATS Board of Directors and by the ERS Executive Committee, February 1999. Am J Respir Crit Care Med. 1999;160(2):736–55.
2.
Zurück zum Zitat Beaumont D, Herry JY, Sapene M, Bourguet P, Larzul JJ, de Labarthe B. Gallium-67 in the evaluation of sarcoidosis: correlations with serum angiotensin-converting enzyme and bronchoalveolar lavage. Thorax. 1982;37(1):11–8. CrossRefPubMedCentralPubMed Beaumont D, Herry JY, Sapene M, Bourguet P, Larzul JJ, de Labarthe B. Gallium-67 in the evaluation of sarcoidosis: correlations with serum angiotensin-converting enzyme and bronchoalveolar lavage. Thorax. 1982;37(1):11–8. CrossRefPubMedCentralPubMed
3.
Zurück zum Zitat Israel HL, Albertine KH, Park CH, Patrick H. Whole-body gallium 67 scans. Role in diagnosis of sarcoidosis. Am Rev Respir Dis. 1991;144(5):1182–6. CrossRefPubMed Israel HL, Albertine KH, Park CH, Patrick H. Whole-body gallium 67 scans. Role in diagnosis of sarcoidosis. Am Rev Respir Dis. 1991;144(5):1182–6. CrossRefPubMed
4.
Zurück zum Zitat Klech H, Kohn H, Kummer F, Mostbeck A. Assessment of activity in sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations. Chest. 1982;82(6):732–8. CrossRefPubMed Klech H, Kohn H, Kummer F, Mostbeck A. Assessment of activity in sarcoidosis. Sensitivity and specificity of 67Gallium scintigraphy, serum ACE levels, chest roentgenography, and blood lymphocyte subpopulations. Chest. 1982;82(6):732–8. CrossRefPubMed
5.
Zurück zum Zitat Line BR, Hunninghake GW, Keogh BA, Jones AE, Johnston GS, Crystal RG. Gallium-67 scanning to stage the alveolitis of sarcoidosis: correlation with clinical studies, pulmonary function studies, and bronchoalveolar lavage. Am Rev Respir Dis. 1981;123(4 Pt. 1):440–6. PubMed Line BR, Hunninghake GW, Keogh BA, Jones AE, Johnston GS, Crystal RG. Gallium-67 scanning to stage the alveolitis of sarcoidosis: correlation with clinical studies, pulmonary function studies, and bronchoalveolar lavage. Am Rev Respir Dis. 1981;123(4 Pt. 1):440–6. PubMed
6.
Zurück zum Zitat Niden AH, Mishkin FS, Salem F, Thomas AV, Jr., Kamdar V. Prognostic significance of gallium lung scans in sarcoidosis. Ann N Y Acad Sci. 1986;465:435–43. CrossRefPubMed Niden AH, Mishkin FS, Salem F, Thomas AV, Jr., Kamdar V. Prognostic significance of gallium lung scans in sarcoidosis. Ann N Y Acad Sci. 1986;465:435–43. CrossRefPubMed
7.
Zurück zum Zitat Nosal A, Schleissner LA, Mishkin FS, Lieberman J. Angiotensin-I-converting enzyme and gallium scan in noninvasive evaluation of sarcoidosis. Ann Intern Med. 1979;90(3):328–31. CrossRefPubMed Nosal A, Schleissner LA, Mishkin FS, Lieberman J. Angiotensin-I-converting enzyme and gallium scan in noninvasive evaluation of sarcoidosis. Ann Intern Med. 1979;90(3):328–31. CrossRefPubMed
8.
Zurück zum Zitat Braun JJ, Kessler R, Constantinesco A, Imperiale A. 18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging. 2008;35(8):1537–43. CrossRefPubMed Braun JJ, Kessler R, Constantinesco A, Imperiale A. 18F-FDG PET/CT in sarcoidosis management: review and report of 20 cases. Eur J Nucl Med Mol Imaging. 2008;35(8):1537–43. CrossRefPubMed
9.
Zurück zum Zitat Glaudemans AW, de Vries EF, Galli F, Dierckx RA, Slart RH, Signore A. The use of (18)F-FDG-PET/CT for diagnosis and treatment monitoring of inflammatory and infectious diseases. Clin Dev Immunol. 2013;2013:623036. CrossRefPubMedCentralPubMed Glaudemans AW, de Vries EF, Galli F, Dierckx RA, Slart RH, Signore A. The use of (18)F-FDG-PET/CT for diagnosis and treatment monitoring of inflammatory and infectious diseases. Clin Dev Immunol. 2013;2013:623036. CrossRefPubMedCentralPubMed
10.
11.
Zurück zum Zitat Gottlieb JE, Israel HL, Steiner RM, Triolo J, Patrick H. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997;111(3):623–31. CrossRefPubMed Gottlieb JE, Israel HL, Steiner RM, Triolo J, Patrick H. Outcome in sarcoidosis. The relationship of relapse to corticosteroid therapy. Chest. 1997;111(3):623–31. CrossRefPubMed
12.
Zurück zum Zitat Baughman RP, Lower EE. Treatment of sarcoidosis with corticosteroids: who is going to relapse and why? Sarcoidosis Vasc Diffuse Lung Dis. 1998;15(1):19–20. PubMed Baughman RP, Lower EE. Treatment of sarcoidosis with corticosteroids: who is going to relapse and why? Sarcoidosis Vasc Diffuse Lung Dis. 1998;15(1):19–20. PubMed
13.
Zurück zum Zitat Hunninghake GW, Gilbert S, Pueringer R, Dayton C, Floerchinger C, Helmers R, et al. Outcome of the treatment for sarcoidosis. Am J Respir Crit Care Med. 1994;149(4 Pt. 1):893–8. CrossRefPubMed Hunninghake GW, Gilbert S, Pueringer R, Dayton C, Floerchinger C, Helmers R, et al. Outcome of the treatment for sarcoidosis. Am J Respir Crit Care Med. 1994;149(4 Pt. 1):893–8. CrossRefPubMed
14.
Zurück zum Zitat Baughman RP, Nunes H, Sweiss NJ, Lower EE. Established and experimental medical therapy of pulmonary sarcoidosis. Eur Respir J. 2013;41(6):1424–38. CrossRefPubMed Baughman RP, Nunes H, Sweiss NJ, Lower EE. Established and experimental medical therapy of pulmonary sarcoidosis. Eur Respir J. 2013;41(6):1424–38. CrossRefPubMed
15.
Zurück zum Zitat Cottin V, Muller-Quernheim J. Sarcoidosis from bench to bedside: a state-of-the-art series for the clinician. Eur Respir J. 2012;40(1):14–6. CrossRefPubMed Cottin V, Muller-Quernheim J. Sarcoidosis from bench to bedside: a state-of-the-art series for the clinician. Eur Respir J. 2012;40(1):14–6. CrossRefPubMed
16.
Zurück zum Zitat Tabak L. Sarkoidoz olgularında uzun dönem izlem sonuçları. Solunum. 2001;3:86–90. Tabak L. Sarkoidoz olgularında uzun dönem izlem sonuçları. Solunum. 2001;3:86–90.
17.
Zurück zum Zitat Zabel P, Entzian P, Dalhoff K, Schlaak M. Pentoxifylline in treatment of sarcoidosis. Am J Respir Crit Care Med. 1997;155(5):1665–9. CrossRefPubMed Zabel P, Entzian P, Dalhoff K, Schlaak M. Pentoxifylline in treatment of sarcoidosis. Am J Respir Crit Care Med. 1997;155(5):1665–9. CrossRefPubMed
18.
Zurück zum Zitat Türktaş H, Oğuzülgen İ, Gürsel G. Effects of pentoxifylline and methylprednisolone combined therapy on sarcoidosis. Turkish Respir J. 2000;1:15–20. Türktaş H, Oğuzülgen İ, Gürsel G. Effects of pentoxifylline and methylprednisolone combined therapy on sarcoidosis. Turkish Respir J. 2000;1:15–20.
19.
Zurück zum Zitat James DG, Carstairs LS, Trowell J, Sharma OP. Treatment of sarcoidosis. Report of a controlled therapeutic trial. Lancet. 1967;2(7515):526–8. CrossRefPubMed James DG, Carstairs LS, Trowell J, Sharma OP. Treatment of sarcoidosis. Report of a controlled therapeutic trial. Lancet. 1967;2(7515):526–8. CrossRefPubMed
20.
Zurück zum Zitat Milman N, Mortensen J, Sloth C. Fluorodeoxyglucose PET scan in pulmonary sarcoidosis during treatment with inhaled and oral corticosteroids. Respiration. 2003;70(4):408–13. CrossRefPubMed Milman N, Mortensen J, Sloth C. Fluorodeoxyglucose PET scan in pulmonary sarcoidosis during treatment with inhaled and oral corticosteroids. Respiration. 2003;70(4):408–13. CrossRefPubMed
21.
Zurück zum Zitat Kaira K, Ishizuka T, Yanagitani N, Sunaga N, Hisada T, Mori M. Value of FDG positron emission tomography in monitoring the effects of therapy in progressive pulmonary sarcoidosis. Clin Nucl Med. 2007;32(2):114–6. CrossRefPubMed Kaira K, Ishizuka T, Yanagitani N, Sunaga N, Hisada T, Mori M. Value of FDG positron emission tomography in monitoring the effects of therapy in progressive pulmonary sarcoidosis. Clin Nucl Med. 2007;32(2):114–6. CrossRefPubMed
22.
Zurück zum Zitat Teirstein AS, Machac J, Almeida O, Lu P, Padilla ML, Iannuzzi MC. Results of 188 whole-body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. Chest. 2007;132(6):1949–53. CrossRefPubMed Teirstein AS, Machac J, Almeida O, Lu P, Padilla ML, Iannuzzi MC. Results of 188 whole-body fluorodeoxyglucose positron emission tomography scans in 137 patients with sarcoidosis. Chest. 2007;132(6):1949–53. CrossRefPubMed
23.
Zurück zum Zitat Brudin LH, Valind SO, Rhodes CG, Pantin CF, Sweatman M, Jones T, et al. Fluorine-18 deoxyglucose uptake in sarcoidosis measured with positron emission tomography. Eur J Nucl Med. 1994;21(4):297–305. CrossRefPubMed Brudin LH, Valind SO, Rhodes CG, Pantin CF, Sweatman M, Jones T, et al. Fluorine-18 deoxyglucose uptake in sarcoidosis measured with positron emission tomography. Eur J Nucl Med. 1994;21(4):297–305. CrossRefPubMed
24.
Zurück zum Zitat Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153–61. CrossRefPubMed Miller MR, Crapo R, Hankinson J, Brusasco V, Burgos F, Casaburi R, et al. General considerations for lung function testing. Eur Respir J. 2005;26(1):153–61. CrossRefPubMed
Metadaten
Titel
Use of PET-CT for the assessment of treatment results in patients with sarcoidosis
verfasst von
MD Aysun Yakar
MD Fatih Yakar
MD Murat Sezer
MD Mehmet Bayram
MD Ezgi Başak Erdoğan
MD Didem Özkan
MD Hatice K. Özçelik
MD Prof. Dr. Levent Tabak
Publikationsdatum
01.04.2015
Verlag
Springer Vienna
Erschienen in
Wiener klinische Wochenschrift / Ausgabe 7-8/2015
Print ISSN: 0043-5325
Elektronische ISSN: 1613-7671
DOI
https://doi.org/10.1007/s00508-014-0647-9

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