Readers should note that we are not suggesting that 99mTc-DP scintigraphy should be performed in patients with sarcoidosis. This imaging modality may add nothing to the present approach to sarcoidosis. Rather, our purpose was to demonstrate that additional trials are warranted. Beyond sarcoidosis, our findings have implications for the role for 99mTc-DP imaging in the management of suspected pulmonary malignancies. In appropriate clinical settings, nuclear radiologists and pulmonologists should consider that activity seen on 99mTc-DP imaging may represent sarcoidosis rather than cancer. Conversely, in patients with known sarcoidosis who are undergoing evaluation for a potential malignancy, 99mTc-DP imaging does not allow one to conclusively differentiate a superimposed malignant process from the underlying disease state. As such, 99mTc-DP imaging should not be considered an acceptable diagnostic alternative to biopsy.
Our study has several limitations. First, although prospective, this trial was cross-sectional in design. We lack information about changes in the results of 99mTc-DP scintigraphy over time. Since sarcoidosis has a variable natural history, such data are crucial before concluding that 99mTc-DP imaging adds to our current approach to the detection of sarcoidosis. Second, our sample size was small. This necessarily limits our ability to draw conclusions. However, this trial was conducted as a pilot study in order to provide preliminary results so as to determine whether further work in this area is warranted. Third, only one center participated in this investigation. As such, our findings have limited gener-alizability. canadian health and care mall
In summary, sarcoidosis often yields positive findings on 99mTc-DP scans. Because of the nexus among the findings of CXRs, PFTs, and 99mTc-DP scintigraphy, future prospective trials are warranted to exploring an expanded role for 99mTc-DP imaging in the evaluation and management of sarcoidosis. In instances in which malignancy is a concern, 99mTc-DP imaging should not be considered an acceptable surrogate for biopsy.