Early 2'-deoxy-2'-[18F]fluoro-D-glucose PET metabolic response after corticosteroid therapy to differentiate cancer from sarcoidosis and sarcoid-like lesions

Mol Imaging Biol. 2009 Jul-Aug;11(4):224-8. doi: 10.1007/s11307-008-0191-y. Epub 2009 Mar 31.

Abstract

Purpose: We aimed at investigating whether early metabolic response to corticosteroid therapy may be used as a diagnostic tool to discriminate between cancer and sarcoidosis, a well-known cause of false-positive 2-deoxy-2-[F-18]fluoro-D: -glucose-positron emission tomography (FDG-PET) findings in oncology.

Procedure: Two cancer patients with biopsy-proven sarcoidosis or sarcoid-like reaction had multiple thoracic FDG foci. After infectious disease had been excluded, patients received oral corticosteroids for 16 and 14 days, respectively, and underwent posttherapeutic FDG-PET examination.

Results: Posttreatment PET revealed a complete metabolic response in both patients, and clinical and imaging follow-up showed no sign of cancer progression.

Conclusion: Early metabolic response to systemic corticosteroid treatment may be used as a tool in the establishment of final diagnosis when sarcoidosis is suspected in a cancer patient and could be capable of differentiating cancer from sarcoidosis in the case of coexisting diseases.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / therapeutic use*
  • Diagnosis, Differential
  • Female
  • Fluorodeoxyglucose F18*
  • Humans
  • Middle Aged
  • Neoplasms / diagnosis*
  • Neoplasms / diagnostic imaging
  • Positron-Emission Tomography*
  • Radiopharmaceuticals*
  • Sarcoidosis / diagnosis*
  • Sarcoidosis / diagnostic imaging
  • Sarcoidosis / drug therapy

Substances

  • Adrenal Cortex Hormones
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18