[67Ga scintigraphy as an aid in the differentiation of fibrosis and granulomatosis in pulmonary sarcoidosis (author's transl)].

Gallium scintigraphy enables the following statements: 1. It is possible to establish the existence of an active granulomatosis both in the acute and in the chronic stage I, as well as the granulomatous pulmonary infiltration of stage II. 2. A therapy-induced or spontaneous regression of granulomatosis is associated with a reduced and later on absent deposition of 67Ga. 3. Signs of fibrosis visible on x-ray film do not exclude the continued presence of granulomatous pulmonary infiltrations. Such a granulomatosis can progress and thus produce further fibrosing and hence functional disorders up to the development of pulmonary heart disease (cor pulmonale.) It follows from this that in such cases corticoid treatment must be continued or resumed. 4. Reduced or no longer apparent storage of 67Ga under therapy does not represent a safeguard against relapse. X-ray controls chould be performed after discontinuation of corticoid therapy in order to discover, if any, discrete signs of recurring granulomatosis. In such cases, gallium scintigraphy can clearly show the revival of granulomatosis. 5. In our opinion, gallium scintigraphy is mandatory in all pulmonary affections.