학술논문

Diagnostic Modalities in Sarcoidosis: BAL, EBUS, and PET
Document Type
Academic Journal
Source
Seminars in Respiratory and Critical Care Medicine. Aug 01, 2010 31(4):404-408
Subject
Language
English
ISSN
1069-3424
Abstract
Advances have been made in minimally invasive diagnostic procedures in sarcoidosis, including bronchoalveolar lavage (BAL), endobronchial ultrasonography-guided transbronchial needle aspiration (EBUS-TBNA), and positron emission tomography (PET). Several independent groups found almost identical predictive values of the CD4:CD8 ratio in BAL for the diagnosis of sarcoidosis. A CD4:CD8 ratio greater than 3.5 shows a high specificity of 93 to 96% for sarcoidosis, but the sensitivity is low (53 to 59%). EBUS-TBNA is a safe and useful tool for diagnosing sarcoidosis stage I and II with a sensitivity of 83 to 93% and a specificity of 100%. Novel imaging techniques have been explored, such as PET using L-[3-F] fluoro-α–methyltyrosine (F-F MT), which is more specific for malignancy than F-fluorodeoxyglucose (F-FDG)-PET. The combined modality of FMT-PET with FDG-PET could successfully discriminate sarcoidosis from malignancy. These recent developments including novel biopsy procedures and novel imaging techniques could be of value to diagnosing sarcoidosis.