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British Journal of Radiology (2007) 80, e67-e71
© 2007 British Institute of Radiology
doi: 10.1259/bjr/33076108
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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

N Aide, MD 1 M Benayoun, MD 1 K Kerrou, MD 1 A Khalil, MD 2 J Cadranel, MD, PhD 3 and J N Talbot, MD, PhD 1

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


Figure 1
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  		Figure 1. (a) [18F]-FDG PET maximum intensity projection view shows thoracic (mediastinal hilar, head arrow) and subdiaphragmatic nodal involvement (hepatic hilar and left groin nodes, black arrows). (b) Sagittal slice shows bony lesions (dotted arrow), involving mostly the axial skeleton and an unusual [18F]-FDG uptake in the middle part of the skull base (white arrow). (c) Brain contrast-enhanced multidetector row CT scan shows an abnormal contrast enhancement of the leptomeninges close to the clivus (sagittal slice), as well as (e) an enlargement of the pituitary gland (12 mm on the coronal slice). (d) The bone window showed an osteolysis of the clivus. This feature was consistent with the diagnosis of neurosarcoidosis.

 

Figure 2
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  		Figure 2. Transverse, sagittal and coronal PET slices, displayed side by side on the CT part of the PET/CT examination, show a moderate [18F]-FDG focus located in the posterior part of the pituitary fossa.

 

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  		Figure 3. A second[18F]-FDG PET [(a) maximum intensity projection (MIP); and (b) whole body sagittal slice] performed after 10 weeks of corticosteroid therapy shows complete disappearance of the pathological [18F]-FDG foci depicted on the first PET scan. (c) The CT part of the PET/CT examination still shows osteoblastic lesions. (d) Contrast-enhanced multidetector row CT scan performed after 10 weeks of treatment with oral corticosteroids shows resolution of leptomeningeal enhancement over the clivus (sagittal slice) and (e) normalization of the appearance of the pituitary gland (coronal slice), as compared with Figure 1Go.

 




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