Background: 18F-FDG PET metabolic imaging provides significant help in the early diagnosis of inflammation of large and medium arteries, even before the appearance of structural vascular alterations. This retrospective study aims to evaluate the role of 18F-FDG PET in the diagnosis and management of large vessel vasculitis (LVV), including aortitis. Methodology: Fifty patients with clinical and/or biological suspicion of large vessel vasculitis but without a definitive diagnosis underwent 18F-FDG PET scanning. A qualitative visual scoring system and an average total vascular score (TVS) were used to compare 18F-FDG uptake in the vascular walls with that in the liver. Patients who had been on corticosteroids for more than 8 days were excluded from the study. Results: The study included 50 patients, 27 women and 23 men, with an average age of 65.8 ± 14.5 years. The analysis of 18F-FDG PET images allowed for the classification of subjects into two distinct groups. Among the 50 subjects, 16 (32%) showed higher 18F-FDG uptake in the vascular walls compared to hepatic uptake (PET-positive group), while 34 (68%) showed lower uptake (PET-negative group). In the positive group, 75% were diagnosed with Horton’s disease, and the remaining 25% with other inflammatory diseases such as Takayasu arteritis or polyarteritis nodosa. None of the subjects in the positive group had an aortic aneurysm. All patients with a positive 18F-FDG PET had elevated levels of C-reactive protein. The TVS obtained for aortitis alone was 5.9 ± 4.7, while the score for more global vasculitis was obviously higher, at 10.4 ± 6.3. Conclusion: 18F-FDG PET has become a valuable tool in the diagnosis of large vessel vasculitis, particularly in the early stages of the disease. It also allows for mapping of arterial involvement and estimation of disease severity using the TVS.
| Published in | International Journal of Medical Imaging (Volume 12, Issue 3) |
| DOI | 10.11648/j.ijmi.20241203.12 |
| Page(s) | 73-81 |
| Creative Commons |
This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited. |
| Copyright |
Copyright © The Author(s), 2024. Published by Science Publishing Group |
18F-FDG PET, Aortitis, Large Vessel Vasculitis, Giant Cell Arteritis
| [1] | Slart RHJA. FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018; 45(7): 1250-1269. |
| [2] | Laurent C, Ricard L, Fain O, et al. PET/MRI in large-vessel vasculitis: clinical value for diagnosis and assessment of disease activity. Sci Rep. 2019; 9(1): 12388. |
| [3] | Antunovic L, Artesani A, Coniglio M, et al. [18F]FDG PET/CT in Large Vessel Vasculitis: The Impact of Expertise and Confounders on Image Analysis. Diagnostics. 2022; 12(11): 2717. |
| [4] | Ben Shimol J, Amital H, Lidar M, Domachevsky L, Shoenfeld Y, Davidson T. The utility of PET/CT in large vessel vasculitis. Sci Rep. 2020; 10(1): 17709. |
| [5] | van der Geest KSM, Treglia G, Glaudemans AWJM, et al. Diagnostic value of [18F] FDG-PET/CT for treatment monitoring in large vessel vasculitis: a systematic review and meta-analysis. Eur J Nucl Med Mol Imaging. 2021; 48(12): 3886-3902. |
| [6] |
Samson M, B. Bonnotte B. How to apply the EULAR and ACR recommendations for the diagnosis and treatment of giant cell arteritis? Rev Med Interne 2022 Mar; 43(3): 135-138.
https://doi.org/10.1016/j.revmed.2022.02.004 Epub 2022 Feb 21. |
| [7] | Balink H, Bennink RJ, van Eck-Smit BLF, Verberne HJ. The Role of 18F-FDG PET/CT in Large-Vessel Vasculitis: Appropriateness of Current Classification Criteria? BioMed Res Int. 2014; 2014: 687608. |
| [8] | Slart RHJA, Nienhuis PH, Glaudemans AWJM, Brouwer E, Gheysens O, Geest KSM van der. Role of 18F-FDG PET/CT in Large Vessel Vasculitis and Polymyalgia Rheumatica. J Nucl Med. 2023; 64(4): 515-521. |
| [9] | Soussan M, Nicolas P, Schramm C, et al. Management of large-vessel vasculitis with FDG-PET: a systematic literature review and meta-analysis. Medicine (Baltimore). 2015; 94(14): e622. |
| [10] | Gribbons KB, Ponte C, Carette S, et al. Patterns of Arterial Disease in Takayasu Arteritis and Giant Cell Arteritis. Arthritis Care Res. 2020; 72(11): 1615-1624. |
| [11] | Treglia G, Albano D, Dondi F, Bertagna F, Gheysens O. A role of FDG PET/CT for Response Assessment in Large Vessel Disease? Semin Nucl Med. 2023; 53(1): 78-85. |
| [12] |
Nielsen BD, Hansen IT, Kramer S, et al. Simple dichotomous assessment of cranial artery inflammation by conventional 18F-FDG PET/CT shows high accuracy for the diagnosis of giant cell arteritis: a case-control study. Eur J Nucl Med Mol Imaging. 2019 Jan; 46(1): 184-193.
https://doi.org/10.1007/s00259-018-4106-0 Epub 2018 Jul 31. |
| [13] |
van der Geest K SM, Sandovici M, Bley TA, et al. Large vessel giant cell arteritis. Lancet Rheumatol.2024 Jun; 6(6): e397-e408.
https://doi.org/10.1016/S2665-9913(23)00300-4 Epub 2024 Apr 1. |
| [14] | Nassarmadji K, Vanjak A, Bourdin V, et al. 18-Fluorodeoxyglucose positron emission tomography/computed tomography for large vessel vasculitis in clinical practice. Front Med. 2023; 10: 1103752. |
| [15] | Malich L, Gühne F, Hoffmann T, et al. Distribution patterns of arterial affection and the influence of glucocorticoids on 18F-fluorodeoxyglucose positron emission tomography/CT in patients with giant cell arteritis. RMD Open. 2022; 8(2): e002464. |
| [16] | Taimen K, Salomäki SP, Hohenthal U, et al. The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment. Contrast Media Mol Imaging. 2019; 2019: 9157637. |
| [17] | Geiger KR, Pasvolsky O, Berger T, et al. Effect of steroid treatment on the diagnostic yield of baseline 18f-fluorodeoxyglucose positron emission tomography in aggressive B cell lymphoma. EJNMMI Res. 2022; 12: 59. |
| [18] | Shelke AB, Aurangabadkar HU, Bradfield JS, Ali Z, Kumar KS, Narasimhan C. Serial FDG-PET scans help to identify steroid resistance in cardiac sarcoidosis. Int J Cardiol. 2017; 228: 717-722. |
| [19] | Influence of Steroid Treatment on 18F-FDG PET/CT Accuracy to Detect Vascular and Musculoeskeletal Involvement in Patients with Polymyalgia Reumatica. ACR Meeting Abstracts. Accessed December 15, 2023. |
| [20] | Blockmans D, de Ceuninck L, Vanderschueren S, Knockaert D, Mortelmans L, Bobbaers H. Repetitive 18F-fluorodeoxyglucose positron emission tomography in giant cell arteritis: a prospective study of 35 patients. Arthritis Rheum. 2006; 55(1): 131-137. |
| [21] | Maksimowicz-McKinnon K, Clark TM, Hoffman GS. Takayasu arteritis and giant cell arteritis: a spectrum within the same disease? Medicine (Baltimore). 2009; 88(4): 221-226. |
| [22] | Bahrami M, Mohammadi H, Mirgaloyebayat H, et al. The role of 18F-fluorodeoxyglucose PET/computed tomography in the diagnosis and monitoring of large vessel vasculitides - a review article. Am J Nucl Med Mol Imaging. 2023; 13(4): 127-135. |
| [23] | Lee YH, Choi SJ, Ji JD, Song GG. Diagnostic accuracy of 18F-FDG PET or PET/CT for large vessel vasculitis : A meta-analysis. Z Rheumatol. 2016; 75(9): 924-931. |
APA Style
Bafail, A., Carsuzaa, T., Legot, F., Santiago-Ribeiro, M. (2024). The Role of 18F-FDG PET in the Diagnosis of Aortitis and Large Vessel Vasculitis. International Journal of Medical Imaging, 12(3), 73-81. https://doi.org/10.11648/j.ijmi.20241203.12
ACS Style
Bafail, A.; Carsuzaa, T.; Legot, F.; Santiago-Ribeiro, M. The Role of 18F-FDG PET in the Diagnosis of Aortitis and Large Vessel Vasculitis. Int. J. Med. Imaging 2024, 12(3), 73-81. doi: 10.11648/j.ijmi.20241203.12
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Download@article{10.11648/j.ijmi.20241203.12,
author = {Abrar Bafail and Thibaut Carsuzaa and Floriane Legot and Maria-Joao Santiago-Ribeiro},
title = {The Role of 18F-FDG PET in the Diagnosis of Aortitis and Large Vessel Vasculitis
},
journal = {International Journal of Medical Imaging},
volume = {12},
number = {3},
pages = {73-81},
doi = {10.11648/j.ijmi.20241203.12},
url = {https://doi.org/10.11648/j.ijmi.20241203.12},
eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijmi.20241203.12},
abstract = {Background: 18F-FDG PET metabolic imaging provides significant help in the early diagnosis of inflammation of large and medium arteries, even before the appearance of structural vascular alterations. This retrospective study aims to evaluate the role of 18F-FDG PET in the diagnosis and management of large vessel vasculitis (LVV), including aortitis. Methodology: Fifty patients with clinical and/or biological suspicion of large vessel vasculitis but without a definitive diagnosis underwent 18F-FDG PET scanning. A qualitative visual scoring system and an average total vascular score (TVS) were used to compare 18F-FDG uptake in the vascular walls with that in the liver. Patients who had been on corticosteroids for more than 8 days were excluded from the study. Results: The study included 50 patients, 27 women and 23 men, with an average age of 65.8 ± 14.5 years. The analysis of 18F-FDG PET images allowed for the classification of subjects into two distinct groups. Among the 50 subjects, 16 (32%) showed higher 18F-FDG uptake in the vascular walls compared to hepatic uptake (PET-positive group), while 34 (68%) showed lower uptake (PET-negative group). In the positive group, 75% were diagnosed with Horton’s disease, and the remaining 25% with other inflammatory diseases such as Takayasu arteritis or polyarteritis nodosa. None of the subjects in the positive group had an aortic aneurysm. All patients with a positive 18F-FDG PET had elevated levels of C-reactive protein. The TVS obtained for aortitis alone was 5.9 ± 4.7, while the score for more global vasculitis was obviously higher, at 10.4 ± 6.3. Conclusion: 18F-FDG PET has become a valuable tool in the diagnosis of large vessel vasculitis, particularly in the early stages of the disease. It also allows for mapping of arterial involvement and estimation of disease severity using the TVS.
},
year = {2024}
}
TY - JOUR T1 - The Role of 18F-FDG PET in the Diagnosis of Aortitis and Large Vessel Vasculitis AU - Abrar Bafail AU - Thibaut Carsuzaa AU - Floriane Legot AU - Maria-Joao Santiago-Ribeiro Y1 - 2024/10/18 PY - 2024 N1 - https://doi.org/10.11648/j.ijmi.20241203.12 DO - 10.11648/j.ijmi.20241203.12 T2 - International Journal of Medical Imaging JF - International Journal of Medical Imaging JO - International Journal of Medical Imaging SP - 73 EP - 81 PB - Science Publishing Group SN - 2330-832X UR - https://doi.org/10.11648/j.ijmi.20241203.12 AB - Background: 18F-FDG PET metabolic imaging provides significant help in the early diagnosis of inflammation of large and medium arteries, even before the appearance of structural vascular alterations. This retrospective study aims to evaluate the role of 18F-FDG PET in the diagnosis and management of large vessel vasculitis (LVV), including aortitis. Methodology: Fifty patients with clinical and/or biological suspicion of large vessel vasculitis but without a definitive diagnosis underwent 18F-FDG PET scanning. A qualitative visual scoring system and an average total vascular score (TVS) were used to compare 18F-FDG uptake in the vascular walls with that in the liver. Patients who had been on corticosteroids for more than 8 days were excluded from the study. Results: The study included 50 patients, 27 women and 23 men, with an average age of 65.8 ± 14.5 years. The analysis of 18F-FDG PET images allowed for the classification of subjects into two distinct groups. Among the 50 subjects, 16 (32%) showed higher 18F-FDG uptake in the vascular walls compared to hepatic uptake (PET-positive group), while 34 (68%) showed lower uptake (PET-negative group). In the positive group, 75% were diagnosed with Horton’s disease, and the remaining 25% with other inflammatory diseases such as Takayasu arteritis or polyarteritis nodosa. None of the subjects in the positive group had an aortic aneurysm. All patients with a positive 18F-FDG PET had elevated levels of C-reactive protein. The TVS obtained for aortitis alone was 5.9 ± 4.7, while the score for more global vasculitis was obviously higher, at 10.4 ± 6.3. Conclusion: 18F-FDG PET has become a valuable tool in the diagnosis of large vessel vasculitis, particularly in the early stages of the disease. It also allows for mapping of arterial involvement and estimation of disease severity using the TVS. VL - 12 IS - 3 ER -
Nuclear Medicine Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France
Nuclear Medicine Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France
Nuclear Medicine Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France
Nuclear Medicine Department, Centre Hospitalier Régional Universitaire (CHRU) de Tours, Tours, France
