Repetitive 18 F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease

Eur J Intern Med. 2017 Dec;46:66-70. doi: 10.1016/j.ejim.2017.08.013. Epub 2017 Sep 1.

Abstract

Objective: 18F-FDG PET/CT can detect large-vessel involvement in giant-cell arteritis (GCA) with a good sensitivity. In patients with clinically and biologically controlled disease, we aimed to assess how vascular uptakes evolve on repetitive FDG-PET/CT.

Patients and methods: All included patients had to satisfy the 4 following criteria: 1) diagnosis of GCA was retained according to the criteria of the American College of Rheumatology or based on the satisfaction of 2 criteria associated with the demonstration of large-vessel involvement on FDG-PET/CT; 2) all patients had a positive PET/CT that was performed at diagnosis before treatment or within the first 10days of treatment; 3) another FDG-PET/CT was performed after at least 3months of controlled disease without any relapse; 4) patients were followed-up at least for 12months.

Results: Twenty-five patients (17 [68%] women, median age: 69 [65-78]) with large-vessel inflammation on a baseline FDG-PET/CT and with repetitive imaging during the period with controlled disease were included and followed-up for 62 [25-95] months. Four repeated procedures revealed total extinction of vascular uptakes at 11.5 [8-12] months after the first FDG-PET/CT. Eight PET/CT revealed decreased numbers of vascular uptakes, and 10 procedures revealed no changes. The 3 remaining procedures indicated worsening of the numbers of vascular uptakes in the absence of relapse.

Conclusions: Our study revealed long-term persistent vascular uptake on repeated FDG-PET/CT in >80% of our GCA patients with large-vessel inflammation and clinical-biological controlled disease. Prospective studies are required to confirm these findings.

Keywords: FDG-PET/CT; Giant-cell arteritis; Large-vessel involvement; Repetitive imaging.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Female
  • Fluorodeoxyglucose F18 / administration & dosage
  • France
  • Giant Cell Arteritis / diagnostic imaging*
  • Humans
  • Male
  • Positron Emission Tomography Computed Tomography*
  • Radiopharmaceuticals / administration & dosage
  • Retrospective Studies

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18