Role of PET/CT in diagnosing and monitoring disease activity in rheumatoid arthritis: a review

Ann Nucl Med. 2024 Mar;38(3):165-175. doi: 10.1007/s12149-023-01896-z. Epub 2024 Jan 26.

Abstract

Rheumatoid Arthritis (RA) is a systemic inflammatory disorder that commonly presents with polyarthritis but can have multisystemic involvement and complications, leading to increased morbidity and mortality. The diagnosis of RA continues to be challenging due to its varied clinical presentations. In this review article, we aim to determine the potential of PET/CT to assist in the diagnosis of RA and its complications, evaluate the therapeutic response to treatment, and predict RA remission. PET/CT has increasingly been used in the last decade to diagnose, monitor treatment response, predict remissions, and diagnose subclinical complications in RA. PET imaging with [18F]-fluorodeoxyglucose ([18F]-FDG) is the most commonly applied radiotracer in RA, but other tracers are also being studied. PET/CT with [18F]-FDG, [18F]-NaF, and other tracers might lead to early identification of RA and timely evidence-based clinical management, decreasing morbidity and mortality. Although PET/CT has been evolving as a promising tool for evaluating and managing RA, more evidence is required before incorporating PET/CT in the standard clinical management of RA.

Keywords: Diagnosis; Fibroblast activation protein inhibitor (FAPI); Monitoring; Positron emission tomography/computed tomography (PET/CT); Rheumatoid arthritis (RA); [18F]-fluorodeoxyglucose ([18F]-FDG); [18F]-sodium fluoride ([18F]-NaF).

Publication types

  • Review

MeSH terms

  • Arthritis, Rheumatoid* / diagnostic imaging
  • Fluorodeoxyglucose F18
  • Humans
  • Positron Emission Tomography Computed Tomography* / methods
  • Positron-Emission Tomography / methods
  • Radiopharmaceuticals

Substances

  • Fluorodeoxyglucose F18
  • Radiopharmaceuticals