F-18 FDG whole-body PET for the assessment of disease activity in patients with rheumatoid arthritis

Clin Nucl Med. 2006 Jul;31(7):386-90. doi: 10.1097/01.rlu.0000222678.95218.42.


PURPOSE OF REPORT: F-18 fluorodeoxyglucose (FDG) positron emission tomography (PET) can be used to image synovitis in patients with rheumatoid arthritis (RA). The aim of this study was to evaluate if a simple scoring system based on visual assessment of FDG joint uptake correlates with the clinical assessment of patients with RA undergoing antiinflammatory treatment.

Materials and methods: Seven patients with active RA underwent whole-body FDG PET and clinical assessment before and after treatment with the antitumor necrosis factor alpha antibody (infliximab). A PET total joint score, ie, the sum of all scores based on FDG uptake intensity between zero and 4 in 28 joints, was correlated with a total joint score based on the clinical disease activity in the same joints using a Spearman rank correlation.

Results: The PET based total joint score was similarly high before onset as was the clinical total joint score. The decrease of FDG joint uptake in the follow-up PET scans correlated significantly with the clinical assessment. Additionally, synovial FDG uptake was found in extraarticular sites such as tendon sheaths and bursae.

Conclusions: Visual assessment of FDG uptake shows a significant correlation with clinical evaluation of disease activity in patients with RA undergoing antiinflammatory treatment.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anti-Inflammatory Agents / therapeutic use
  • Antibodies, Monoclonal / therapeutic use
  • Arthritis, Rheumatoid / blood
  • Arthritis, Rheumatoid / diagnostic imaging*
  • Arthritis, Rheumatoid / drug therapy
  • Blood Sedimentation
  • C-Reactive Protein / analysis
  • Female
  • Fluorodeoxyglucose F18* / pharmacokinetics
  • Humans
  • Infliximab
  • Joints / diagnostic imaging
  • Male
  • Middle Aged
  • Pilot Projects
  • Positron-Emission Tomography*
  • Radiopharmaceuticals* / pharmacokinetics
  • Severity of Illness Index*


  • Anti-Inflammatory Agents
  • Antibodies, Monoclonal
  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18
  • C-Reactive Protein
  • Infliximab