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European Journal of Nuclear Medicine and Molecular Imaging

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Open Access 01-08-2014 | Original Article

Characterizing IgG4-related disease with ¹⁸F-FDG PET/CT: a prospective cohort study

Authors: Jingjing Zhang, Hua Chen, Yanru Ma, Yu Xiao, Na Niu, Wei Lin, Xinwei Wang, Zhiyong Liang, Fengchun Zhang, Fang Li, Wen Zhang, Zhaohui Zhu

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2014

Abstract

Purpose

IgG4-related disease (IgG4-RD) is an increasingly recognized clinicopathological disorder with immune-mediated inflammatory lesions mimicking malignancies. A cohort study was prospectively designed to investigate the value of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in characterizing IgG4-RD.

Methods

Thirty-five patients diagnosed with IgG4-RD according to the consensus criteria were enrolled with informed consent. All patients underwent baseline ¹⁸F-FDG PET/CT evaluation. Among them, 29 patients underwent a second ¹⁸F-FDG PET/CT scan after 2 to 4 weeks of steroid-based therapy.

Results

All 35 patients were found with ¹⁸F-FDG-avid hypermetabolic lesion(s); 97.1 % (34/35) of these patients showed multi-organ involvement. Among the 35 patients, 71.4 % (25/35) patients were found with more organ involvement on ¹⁸F-FDG PET/CT than conventional evaluations including physical examination, ultrasonography, and computed tomography (CT). ¹⁸F-FDG PET/CT demonstrated specific image characteristics and pattern of IgG4-RD, including diffusely elevated ¹⁸F-FDG uptake in the pancreas and salivary glands, patchy lesions in the retroperitoneal region and vascular wall, and multi-organ involvement that cannot be interpreted as metastasis. Comprehensive understanding of all involvement aided the biopsy-site selection in seven patients and the recanalization of ureteral obstruction in five patients. After 2 to 4 weeks of steroid-based therapy at 40 mg to 50 mg prednisone per day, 72.4 % (21/29) of the patients showed complete remission, whereas the others exhibited > 81.8 % decrease in ¹⁸F-FDG uptake.

Conclusion

F-FDG PET/CT is a useful tool for assessing organ involvement, monitoring therapeutic response, and guiding interventional treatment of IgG4-RD. The image pattern is suggested to be updated into the consensus diagnostic criteria for IgG4-RD.

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Title: Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study
Authors: Jingjing Zhang
Hua Chen
Yanru Ma
Yu Xiao
Na Niu
Wei Lin
Xinwei Wang
Zhiyong Liang
Fengchun Zhang
Fang Li
Wen Zhang
Zhaohui Zhu
Publication date: 01-08-2014
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2014
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-014-2729-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Characterizing IgG4-related disease with ¹⁸F-FDG PET/CT: a prospective cohort study

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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