Is positron emission tomography/magnetic resonance imaging a reliable tool for detecting vascular activity in treated childhood-onset Takayasu's arteritis? A multicentre study. (15th March 2021)

• Record Type: Journal Article
• Authors: Clemente, Gleice; Pereira, Rosa M R; Aikawa, Nadia; Silva, Clovis A; Campos, Lucia M A; Alves, Gabriel; Buchpiguel, Carlos; Lima, Marcos; Carneiro, Camila; Filho, Hilton L; Morbeck, Fernando; Neto, Guilherme; Filho, Vicente O; Souza, Alexandre W D; Terreri, Maria Teresa
• Is Part Of: Rheumatology. Volume 61:Number 2(2022)
• Page Start: 554
• Page End: 562
• Publication Date: 2021-03-15
• Subjects: Takayasu's arteritis -- PET/MRI -- 18F-FDG PET -- children -- disease activity; Rheumatism -- Periodicals; Rheumatology -- Periodicals; 616.723005
• DOI: 10.1093/rheumatology/keab255
• Languages: English
• ISSNs: 1462-0324

Abstract

Abstract: Objectives: Toassess whether 18 F-fluordeoxiglucose ( 18 F-FDG) PET/MRI) with angiographic sequences can contribute to detecting vessel wall inflammation in patients with childhood-onset Takayasu's arteritis (c-TA) under immunosuppressive therapy. Methods: A three-centre cross-sectional study was conducted. 18 F-FDG PET/MRI scans were performed in c-TA patients and in oncologic patients, who served as the control group. Clinical and laboratory characteristics were also analysed. Results: Seventeen c-TA patients (65% females) between the ages of 6 and 21 years with a mean disease duration of 9.4 years were recruited. Only one patient presented clinical disease activity and six (35.6%) had increased ESR and/or CRP levels. The most frequent magnetic resonance angiography (MRA) findings were stenosis and thickening, observed in 82.4 and 70.6% of c-TA patients, respectively. 18 F-FDG PET revealed 18 F-FDG uptake greater than the liver in at least one arterial segment in 15 (88.2%) patients in a qualitative analysis and a median maximum standardized uptake value (SUVmax ) of 3.22 (interquartile range 2.76–3.69) in a semi-quantitative analysis. c-TA patients presented significantly higher SUVmax values than oncologic patients ( P < 0.001). A positive correlation between SUVmax and CRP levels (ρ = 0.528, P = 0.029) was seen. Conclusion: A state-of-the-art imaging modality was used in c-TA patients and revealed a strong arterial FDG uptake even in patients in apparent remission. We suppose that this finding may represent silent activity in the vessel wall; however, we cannot exclude the possibility of arterial remodelling. Importantly, a negative imaging scan may help in immunosuppression withdrawal in daily clinical practice.