Usefulness of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging and evaluation of treatment response in IgG4-related disease: a retrospective multicenter study

Arthritis Care Res (Hoboken). 2014 Jan;66(1):86-96. doi: 10.1002/acr.22058.

Abstract

Objective: To evaluate the usefulness of 2-[18F]-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography (FDG-PET/CT) in IgG4-related disease (IgG4-RD) for the staging of the disease and the followup under treatment.

Methods: All patients included in the French IgG4-RD registry who underwent ≥1 FDG-PET/CT scan were included in the study. Clinical, biologic, pathologic, radiologic, and FDG-PET/CT qualitative and quantitative findings were retrospectively collected and analyzed.

Results: Twenty-one patients were included in the study and 46 FDG-PET/CT examinations were evaluated. At either diagnosis or relapse, all evaluated patients presented abnormal 18F-FDG uptake in typical IgG4-RD localizations. In most cases, FDG-PET/CT was more sensitive than conventional imaging to detect organ involvement, especially in arteries, salivary glands, and lymph nodes. In few cases (small-sized lesions and brain or kidney contiguous lesions), false-negative results were noted. Evaluation before and after treatment showed in most cases a good correlation of FDG-PET/CT results with treatment response and disease activity.

Conclusion: This large retrospective study shows that FDG-PET/CT imaging is useful for the staging of IgG4-RD. Moreover, FDG-PET/CT is useful to assess the response to treatment during followup.

Publication types

  • Evaluation Study
  • Multicenter Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antibodies, Monoclonal, Murine-Derived / therapeutic use
  • Antirheumatic Agents / therapeutic use*
  • Female
  • Fluorodeoxyglucose F18 / metabolism
  • Humans
  • Immunoglobulin G / metabolism*
  • Immunosuppressive Agents / therapeutic use
  • Male
  • Middle Aged
  • Multiple Organ Failure / diagnosis*
  • Multiple Organ Failure / drug therapy*
  • Multiple Organ Failure / metabolism
  • Positron-Emission Tomography / methods*
  • Prednisone / therapeutic use
  • Retrospective Studies
  • Rituximab
  • Sensitivity and Specificity
  • Severity of Illness Index*
  • Steroids / therapeutic use
  • Tomography, X-Ray Computed / methods*
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal, Murine-Derived
  • Antirheumatic Agents
  • Immunoglobulin G
  • Immunosuppressive Agents
  • Steroids
  • Fluorodeoxyglucose F18
  • Rituximab
  • Prednisone