Medical Radiology and Radiation Safety. 2021. Vol. 66. № 3. С. 55–61

V.P. Zolotnitskaia¹, I.V. Amosov¹, O.P. Baranova¹, A.P. Litvinov¹, V.I. Amosov¹,
A.A. Speranskaia¹, V.A. Ratnikov²

SPECT with ⁶⁷Ga Citrate in the Diagnosis of Systemic Sarcoidosis

¹Academician I.P. Pavlov First St.-Petersburg State Medical University, St. Petersburg, Russia

²Sokolov Hospital № 122, St. Petersburg, Russia

Contact person: Valentina Petrovna Zolotnitskaia: This email address is being protected from spambots. You need JavaScript enabled to view it.

Abstract

Purpose: To study the possibilities of using 67Ga-citrate in patients with systemic manifestations of sarcoidosis to identify foci of pathological accumulation of the drug and assess the degree of process activity.

Material and methods: Radionulide study with 67Ga-citrate was performed in 140 patients with respiratory sarcoidosis and suspected extrapulmonary localization. In addition, all patients underwent X-ray examination of the lungs, MSCT of the organs of the chest and abdominal cavity, SPECT of the lungs with radiopharmaceutical macroaggregates of albumin, ultrasound of the abdomen, pelvis, MRI of the head was performed in 16 patients with suspected neurosarcoidosis.

Results: Most patients (n = 125) showed changes in the lungs, manifested by a bright glow (yellow or purple) on the computer screen, which indicated a pronounced impaired function of lymphoid tissue. In 22 patients, the changes were recurrent. The results correlated with published data on damage to the nervous system (r = 0.96), musculoskeletal system (r = 0.97), parotid glands (r = 0.91), liver, spleen (r = 0.83) . At the same time, the results for eye damage (r = 0.23), ENT organs (r = 0.15), intestines (r = 0.48) were significantly different. In our study, no heart lesions were detected in any case.

Conclusions: The use of positive scintigraphy with Ga-67 citrate, taking into account the whole body scan and SPECT of areas of interest of interest (chest cavity, abdominal cavity, head, pelvis) is effective for the diagnosis of systemic sarcoidosis and in determining the activity of the process. The study is recommended to be performed 72 hours after intravenous administration of the drug.

The combination of CT, MRI and radionuclide studies allows you to obtain reliable information about the activity of the process, to identify the localization of increased metabolic activity, that is, the topography of active sarcoidosis.

Key words: sarcoidosis, 67Ga-citrate, SPECT

For citation: Zolotnitskaia VP, Amosov IV,.Baranova OP, Litvinov AP, Amosov VI, Speranskaia AA, Ratnikov VA. SPECT with 67Ga citrate in the diagnosis of systemic sarcoidosis. Medical Radiology and Radiation Safety. 2021;66(3):55-61.

DOI: 10.12737/1024-6177-2021-66-3-55-61

References

1. Landi C, Carleo A, Cillis G, Rottoli P. Sarcoidosis: Proteomics and new Perspectives for Improving Personalized Medicine. Expert. Rev. Proteomics. 2018;15;10:829-835. DOI: 10.1080/14789450.2018.152 8148. 
2. Vizel' AA, Vizel' IYu, Amirov NB Epidemiology of Sarcoidosis in the Russian Federation. Vestnik Sovremennoi Klinicheskoi Meditsiny. 2017;5:66-73 (In Russian) DOI: 10.20969/VSKM.2017.10(5). 66-73.
3. Tikhonovich EL, Vezikova NN, Markelova OA, Malysheva I.E. Epidemiology, Clinical Features, Diagnosis and Treatment of Sarcoidosis in Karelia. Uchen. app. Petrozavod. State un-that. Ser. Natural and Technical Sciences. 2015;6;151:67-71 (In Russian).
4. Elizabeth V, Arkema EV, Johan Grunewald J, Kullberg S, et al. Sarcoidosis Incidence and Prevalence: a Nationwide Register-based Assessment in Sweden. Eur. Respir. J. 2016;48:1545-1548.
5. Baughman RP, Field S, Costabel U et al. Sarcoidosis in America. Analysis Based on Health Care Use. Ann Am Thorac Soc. 2016;13;8:1244-52. DOI: 10.1513/AnnalsATS.201511-760OC. 
6. Fomin VV, Brovko MYu. Kalashnikov MV, Sholomova VI, Rozina TP, Akulkina LA, Pershina AE, Yanakaeva ASh, Nekrasova TP. Damage to the Liver with Sarcoidosis. Therapeutic Archive. 2019;04:4-12 (In Russian). DOI: 10.26442/00403660.2019.04. 000179
7. Ungprasert P, Matteson EL Neurosarcoidosis. Rheum. Dis. Clin. North Am. 2017;43;4:593-606. Epub 2017. Aug. 23.  DOI: 10.1016/j.rdc.2017.06.008.
8. Ibitoye RT, Wilkins A, Scolding NJ Neurosarcoidosis: a Clinical Approach to Diagnosis and Management  J. Neurol. 2017;264;5:1023-1028. DOI: 10.1007/s00415-016-8336-4.
9. Vizel' AA, Amirov NB. Sarcoidosis and Organ Damage in the Digestive System. Vestnik Sovremennoi Klinicheskoi Meditsiny. 2010;1:43-50 (In Russian).
10. Valeyre D, Prasse A, Nunes H, Uzunhan Y, Brillet PY, Müller-Quernheim J. Sarcoidosis. Lancet. 2014;383;9923:1155-67. DOI: 10.1016 /S0140-6736(13)60680-7 
11. Lebedeva MV, Popova EN, Ponomarev AB, et al. Extrapulmonary Manifestations of Sarcoidosis. Vrach. 2011;3:43-5 (In Russian).
12. El Sayed F, Torbey G, Youssef H, Chababi M. Childhood Sarcoidosis: Diagnostic Issues. Dermatol. Online J. 2013. V.19, No.10. P.20037
13. Lishmanov YuB, Chernov VI. Radionuclide Diagnostics for Medical Practitioners. Tomsk.: STT, 2004. 394 p. (In Russian).
14. Gezer N, Başara I, Altay C, Harman M, Rocher L, Karabulut N, Seçil M. Abdominal Sarcoidosis: Cross-Sectional Imaging Findings. Diagn Interv Radiol. 2015. V.21, No.2. P.111-7. DOI: 10.5152/ dir.2014.14210
15. Chapman MN, Fujita A, Sung EK, Siegel C. Nadgir RN, Saito N, Sakai O. Sarcoidosis in the Head and Neck: an Illustrative Review of Clinical Presentations and Imaging Findings  AJR Am. J. Roentgenol. 2017. V.208, No.1. P.66-75. DOI: 10.2214/ AJR.16.16058.
16. Heinle R, Chang C. Diagnostic Criteria for Sarcoidosis. Autoimmun Rev. 2014. V.13, No.5. P.383-387. DOI: 10.1016/j.autrev.2014. 01.035
17. Aratfni T, Narabayashy I, Komori N, et al. Usefulness of Tc-99mMIBI SPECT in Predicting Multidrug Gene Expression Levels in Non-Small Cell Lung Cancer a Preliminary. Ann Nucl. Med. 2001;15;4:313-319.
18. Korchagina EO. Results of Clinical and Radionuclide Studies in Patients with Respiratory Sarcoidosis. Ukrainian Medical Almanac. 2009;12;2:85-87 (In Russian).
19. Videnovic, Ivanov J, Vucinic Mihailovic V, Artiko V, et al. Responsiveness of FDG PET/CT to Treatment of Patients with Active Chronic Sarcoidosis. Clin. Nucl. Med. 2013;38;7:516-521.
20. Zaitsev AA, Antipushina DN, Sivokozov IV. Practical Possibilities of PET / CT in Assessing the Activity and Prevalence of Sarcoidosis. Pulmonology. 2013;6:119-122 (In Russian).

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Conflict of interest. The authors declare no conflict of interest.

Financing. The study had no sponsorship.

Contribution. Article was prepared with equal participation of the authors.

Article received: 23.12.2020. 

Accepted for publication: 20.01.2021.