PET/CT as a Surrogate for Monitoring Treatment Outcomes in Sarcoidosis

Sarcoidosis is a multisystem granulomatous disease with no single reliable marker to monitor treatment response. FDG-PET/CT enables visualization of active inflammation and differentiation from irreversible fibrotic disease. We conducted a narrative review and a case series of ten pulmonary sarcoidosis patients followed at an academic tertiary-care center, comparing baseline and 1-year PET/CT findings with clinical status and treatment changes. After 1 year, 5 patients demonstrated clinical improvement with medication reduction, accompanied by decreased lesion burden and SUV on PET/CT, including complete resolution in several cases. Biomarkers did not consistently correlate with imaging findings. These results support FDG-PET/CT as a valuable adjunct for assessing treatment response when conventional markers are inconclusive.