Lacrimal gland uptake of ⁶⁷Ga-gallium citrate correlates with biopsy results in patients with suspected sarcoidosis

Purpose: To investigate whether lacrimal gland uptake on ⁶⁷Ga-gallium citrate scintigraphy correlates with histopathologic evidence of sarcoidosis. Methods: A retrospective, pilot study of 31 patients with suspected sarcoidosis who underwent gallium scintigraphy and lacrimal gland biopsy. Lacrimal gland gallium uptake was assessed by subjective visual scoring (SVS) and lacrimal uptake ratio (LUR). Results: Eleven (36%) patients had lacrimal gland biopsies containing noncaseating granulomas. A statistically significant correlation was found between lacrimal gland gallium uptake and biopsy positivity using SVS (p=0.03) or LUR (p=0.01). Using SVS, biopsy positivity rate increased from 0 to 50% in patients with mild to intense uptake. Using LUR, biopsy positivity rate increased linearly as the ratio increased from 13% (LUR<4) to 100% (LUR>8). Conclusions: Lacrimal biopsy positivity rate significantly correlated with gallium uptake on scintigraphy. Both SVS and LUR methods appear to correlate with histologic results and may potentially aid in patient selection for biopsy.