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[18F]-FDG PET and PET/CT examinations in early diagnosis of giant cell arteritis a cohort of 39 patients



Rok publikování 2012
Druh Konferenční abstrakty
Popis Giant cell arteritis is classified among large-vessel vasculitis. Its first manifestation may be a febrile state with elevation in inflammation markers (ESR, CRP) and for examinations of such patients it is possible to use PET (PET/CT) scanning. Aim: To verify if high 18F-FDG uptake in the walls of large vessels is corresponding with giant cell arteritis. Patients and methods: Based on PET (25 pts) and PET/CT (14 pts) examinations, 39 patients with suspicion of large-vessel vasculitis formed a cohort in which were 30 males and 9 females aged 45-81 with a mean age of 64.9 and median of 65 years. For verifying, a direct proof using histologic examination of a vessel excision (4 pts) or an indirect one - a therapeutic test for ESR and CRP decreases during corticotherapy in immunosuppressive doses (39 pts) were opted. FDG uptake was measured in 7 vessel areas with an area evaluated as positive when it surpassed an uptake of the liver parenchyma. As a control group a sample of 100 patients free from vasculitis was used. For comparison, results from further imaging examinations were used. Results: Giant cell arteritis was proved in 3 from 4 histologic examinations. By indirect testing, vasculitis in all 39 patients was confirmed. In patients with vasculitis before the use of corticotherapy, positivity of at least 3 vessel areas was found, whereas in the control group positivity was observed in 0-2 vessel areas. Further imaging examinations did not detect clear symptoms of vasculitis, it could be evaluated as abnormal. Conclusions: The finding of generalized high 18F-FDG uptake in large vessels in patients with symptoms of active inflammatory disease gave evidence for large-vessel vasculitis. The PET (PET/CT) examinations detected the disease in its early phase and also determined the extent thereof. Direct imaging of afflicted temporal vessels was successful only by using a hybrid PET/CT scanner.

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