Positron emission tomography assessment of large vessel inflammation in patients with newly diagnosed, biopsy-proven giant cell arteritis: a prospective, case–control study. Issue 7 (24th March 2014)

• Record Type: Journal Article
• Authors: Prieto-González, Sergio; Depetris, Marina; García-Martínez, Ana; Espígol-Frigolé, Georgina; Tavera-Bahillo, Itziar; Corbera-Bellata, Marc; Planas-Rigol, Ester; Alba, Marco A; Hernández-Rodríguez, José; Grau, Josep M; Lomeña, Franciso; Cid, Maria C
• Is Part Of: Annals of the rheumatic diseases. Volume 73:Issue 7(2014)
• Page Start: 1388
• Page End: 1392
• Publication Date: 2014-03-24
• Subjects: large-vessel vasculitis -- giant-cell arteritis -- inflammation -- diagnosis -- positron-emission tomography -- imaging -- interleukin-6 -- acute-phase reactants; Rheumatism -- Periodicals; 616.723005
• DOI: 10.1136/annrheumdis-2013-204572
• Languages: English
• ISSNs: 0003-4967

Abstract

Abstract : Background: Positron emission tomography (PET) scan is emerging as a promising imaging technique to detect large-vessel inflammation in giant cell arteritis (GCA). However, the lack of a standardised definition of arteritis based on 18 fluorodeoxyglucose (FDG) uptake is an important limitation to the use of PET scan for diagnostic purposes. Objective: To prospectively assess the intensity and distribution of FDG uptake at different vascular territories in patients with newly diagnosed GCA compared with controls. Methods: 32 consecutive, biopsy-proven, GCA patients treated with glucocorticoids for ≤3 days were included. The control group consisted of 20 individuals, who underwent PET/CT for cancer staging. Maximal standardised uptake value (SUVm) was calculated at four aortic segments, supraaortic branches and iliac-femoral territory. Sensitivity and specificity was calculated by receiver–operator characteristic curves (ROC) analysis. Results: Mean SUVm was significantly higher in patients than in controls in all vessels explored and correlated with acute-phase reactants and serum IL-6. Mean of the SUVm at all the vascular territories had an area under the curve (AUC) of 0.830, and a cut-off of 1.89 yielded a sensitivity of 80% and a specificity of 79% for GCA diagnosis. There were no significant differences in AUC among the vascular beds examined. Conclusions: FDG uptake by large vessels has a substantial sensitivity and specificity for GCA diagnosis.