NDLI: 18F-FDG uptake in main arterial branches of patients with large vessel vasculitis: visual and semiquantitative analysis.

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18F-FDG uptake in main arterial branches of patients with large vessel vasculitis: visual and semiquantitative analysis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Castellani, Massimo Vadrucci, Manuela Florimonte, Luigia Caronni, Monica Benti, Riccardo Bonara, Paola
Description	Country affiliation: Italy Author Affiliation: Castellani M ( Department of Nuclear Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, pad. Granelli, Via F. Sforza, 35, 20122, Milan, Italy. mcastell@policlinico.mi.it.); Vadrucci M ( Department of Nuclear Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, pad. Granelli, Via F. Sforza, 35, 20122, Milan, Italy.); Florimonte L ( Department of Health Sciences, University of Milan, Milan, Italy.); Caronni M ( Department of Nuclear Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, pad. Granelli, Via F. Sforza, 35, 20122, Milan, Italy.); Benti R ( Referral Center for Systemic Autoimmune Diseases, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy.); Bonara P ( Department of Nuclear Medicine, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, pad. Granelli, Via F. Sforza, 35, 20122, Milan, Italy.)
Abstract	OBJECTIVE: Over the last decade, the contribution of (18)F-FDG (FDG) PET/CT imaging to the diagnosis of large vessel vasculitis has been widely investigated. The aim of this study was to evaluate a more extensive role for PET/CT in grading vascular inflammation in patients with different clinical stages of disease. METHODS: The images of 66 PET/CT studies of 34 patients, performed at diagnosis and/or during follow-up were reviewed. FDG uptake in different regions of aorta and in its major branches was visually (regional Score: rS) and semiquantitatively (regional SUVmean: rSUV) assessed. The global vascular uptake was also evaluated for each study by summing all rSs (summed Score; sS) and averaging rSUVs (averaged SUV; aSUV). FDG uptake in 15 PET/CT studies of control age-matched subjects without signs or symptoms of vasculitis was also analyzed. RESULTS: Higher levels of regional and global FDG uptake were found at diagnosis in comparison with follow-up studies of 12 patients with complete longitudinal observation (p value range 0.0552-0.0026). In the latter group high values were generally observed when disease relapse or incomplete response to therapy (active disease) occurred, whereas lower uptake was found in studies of remitted patients (p = <0.01), whose FDG levels were similar to those of control subjects. At ROC analysis performed on all image dataset, optimal cut-off levels of regional and global FDG vascular uptake provided a good discrimination between 25 patients at diagnosis and 15 control subjects (aSUV greater than 0.697; PPV = 92.3; NPV = 92.9). Major overlap was observed among FDG levels of 21 patients with active disease and in remission (aSUV greater than 0.653; PPV = 58.3; NPV = 94.1). Similar performances of visual and semiquantitative analyses were found when areas under curves (AUCs) were compared. CONCLUSIONS: (18)F-FDG PET/CT has a promising role in grading inflammation in patients with large arteries vasculitis. Nevertheless, a cut-off based analysis of FDG vascular uptake is not sufficient to separate patients with active and inactive disease during follow-up.
File Format	HTM / HTML
ISSN	09147187
Issue Number	6
Journal	Annals of Nuclear Medicine
Volume Number	30
e-ISSN	18646433
Language	English
Publisher	Springer
Publisher Date	2016-07-01
Publisher Place	Japan
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Nuclear Medicine
Content Type	Text
Resource Type	Article
Subject	Radiology, Nuclear Medicine and Imaging

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