18-FDG PET for large vessel vasculitis diagnosis and follow-up

Clin Exp Rheumatol. 2021 Mar-Apr;39 Suppl 129(2):76-82. doi: 10.55563/clinexprheumatol/3cneda. Epub 2020 Dec 9.

Abstract

Objectives: Large vessel vasculitis (LVV) are chronic inflammatory diseases that affect arteries. While a mere clinical-serological approach does not seem sensitive either in the initial evaluation nor in long-term monitoring, 18-FDG positron emission tomography (18-FDG PET) is currently considered a useful assessment tool in LVV. We aimed at exploring the utility of 18-FDG, compared with traditional assessments, in the short- and long-term follow-up of patients with LVV. In addition, we compared patterns of vascular involvement in patients with Takayasu's arteritis (TAK) and giant cell arteritis (GCA).

Methods: We retrospectively analysed 47 patients affected by LVV, evaluating clinics, blood chemistry and 18-FDG PET results, at two time points, short-term (average 8 months after diagnosis) and long-term (average 29 months).

Results: 18-FDG PET uptake, expressed as mean value of SUV max, decreased significantly during follow-up in all the patients. A low concordance between 18-FDG PET and acute phase reactants levels was observed, but also a good sensitivity in detecting the response to treatment.

Conclusions: The results confirm the role of 18-FDG PET as a powerful tool in the evaluation of LVV, both at the time of diagnosis and during monitoring. Furthermore, the data confirm that GCA and TAK are part of the same disease spectrum.

MeSH terms

  • Fluorodeoxyglucose F18
  • Follow-Up Studies
  • Giant Cell Arteritis* / diagnostic imaging
  • Humans
  • Positron Emission Tomography Computed Tomography
  • Positron-Emission Tomography
  • Radiopharmaceuticals
  • Retrospective Studies
  • Takayasu Arteritis* / diagnostic imaging

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18