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European Journal of Nuclear Medicine and Molecular Imaging
Published in: European Journal of Nuclear Medicine and Molecular Imaging 8/2019

01-07-2019 | Giant Cell Arteritis | Original Article

Risk of ischaemic events at giant cell arteritis diagnosis according to PET/CT findings

Authors: Jaume Mestre-Torres, Marc Simó-Perdigó, Fernando Martínez-Valle, Ignacio Navales, Jose Loureiro-Amigo, Roser Solans-Laque

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 8/2019

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Abstract

Purpose

To analyse the risk of ischaemic events in patients with newly diagnosed giant cell arteritis (GCA) according to PET/CT findings.

Methods

PET/CT was performed during the first 10 days of steroid therapy. Clinical manifestations at diagnosis, and physical examination and PET/CT findings were recorded and compared according to the presence or absence of ischaemic symptoms at disease onset. Analysed territories included the ascending aorta, aortic arch, descending aorta, abdominal aorta, carotid arteries, brachiocephalic trunk, vertebral arteries, subclavian arteries and axillary arteries.

Results

The study group comprised 30 patients with a median age of 80.8 years. Of these patients, 21 (70%) reported ischaemic symptoms at diagnosis, and 13 (43.3%) had permanent visual loss. Of the 30 patients, 77.8% showed large vessel vasculitis (including aortic and vertebral artery involvement) on PET/CT, and 60% had isolated involvement of the vertebral territory. Vertebral arteries were more frequently involved in patients with ischaemic symptoms (OR 5.0, 95% CI 0.99–24.86, p = 0.051). The presence of vertebral artery involvement in the absence of aortic involvement was associated with the presence of ischaemic manifestations (Fisher’s exact test, p = 0.001). The presence of aortitis was found to protect against the development of permanent visual loss (OR 19.0, 95% CI 2.79–127.97, p = 0.001).

Conclusion

Our findings suggest an association between the vascular pattern on PET/CT at the time of GCA diagnosis and the risk of ischaemic events.
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Metadata
Title
Risk of ischaemic events at giant cell arteritis diagnosis according to PET/CT findings
Authors
Jaume Mestre-Torres
Marc Simó-Perdigó
Fernando Martínez-Valle
Ignacio Navales
Jose Loureiro-Amigo
Roser Solans-Laque
Publication date
01-07-2019
Publisher
Springer Berlin Heidelberg
Published in
European Journal of Nuclear Medicine and Molecular Imaging / Issue 8/2019
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI
https://doi.org/10.1007/s00259-019-04339-y

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