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Impact of [¹⁸F]-fluorodeoxyglucose ([¹⁸F]-FDG) imaging in sarcoidosis: unsuspected neurosarcoidosis discovered by [¹⁸F]-FDG PET and early metabolic response to corticosteroid therapy

¹ Hôpitaux de Paris PET centre, Departments of ² Radiology and ³ Pneumology, Hôpital Tenon AP-HP et Université Pierre et Marie Curie, Paris, France

Correspondence: Nicolas Aide, Department of Nuclear Medicine, Centre François Baclesse, Avenue du general Harris, 14000 Caen, France. E-mail: n.aide{at}baclesse.fr

A 46-year-old woman, with biopsy proven pulmonary sarcoidosis, was referred for an [¹⁸F]-FDG PET/CT scan that depicted multivisceral involvement and an unusual [¹⁸F]-FDG focus located in the pituitary fossa consistent with pituitary sarcoidosis. This was confirmed by decreased antidiuretic hormone blood levels and contrast-enhanced CT scan. This unsuspected neurosarcoidosis prompted corticosteroid therapy. A [¹⁸F]-FDG-PET/CT examination performed 10 weeks after initiation of treatment revealed complete recovery. It is suggested that the skull base should be included in the PET scanning of patients with sarcoidosis. [¹⁸F]-FDG imaging may be useful in the early evaluation of response to treatment.