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European Journal of Nuclear Medicine and Molecular Imaging

Published in:

01-07-2017 | Original Article

¹⁸F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu’s arteritis

Authors: Elena Incerti, Enrico Tombetti, Federico Fallanca, Elena M. Baldissera, Pierpaolo Alongi, Elisabetta Tombolini, Silvia Sartorelli, Maria Grazia Sabbadini, Maurizio Papa, Francesco De Cobelli, Justin C. Mason, Luigi Gianolli, Angelo A. Manfredi, Maria Picchio

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 7/2017

Abstract

Purpose

The object of this study was to assess whether ¹⁸F-fluorodeoxyglucose PET/CT (FDG PET/CT) provides novel information in patients with Takayasu’s arteritis (TA) in addition to that provided by current activity assessment, to analyse the effects of possible confounders, such as arterial grafts, and to verify whether PET/CT could be informative in lesions <4 mm thick.

Methods

We studied 30 patients with TA, evaluated from October 2010 to April 2014 by both PET/CT and magnetic resonance imaging (MRI). All arterial lesions were evaluated by PET both qualitatively (positive/negative) and semiquantitatively (maximum standardized uptake value, SUV_max), and the thickness of lesions in the MRI field of view was evaluated. In a per-patient analysis, the relationships between the PET data and acute-phase reactants and NIH criteria for active TA were evaluated. In a per-lesion analysis, the relationships between the PET features of each lesion and MRI morphological data were evaluated. The effects of the presence of arterial grafts were also evaluated.

Results

Increased FDG uptake was seen in 16 of 30 patients (53%) and in 46 of 177 vascular lesions (26%). Significant periprosthetic FDG uptake was seen in 6 of 7 patients (86%) with previous vascular surgery and in 10 of 11 of grafts (91%). Graft-associated uptake influenced the PET results in three patients (10%) and the SUV_max values in five patients (17%). Of 39 lesions with significant FDG uptake, 15 (38%) were <4 mm thick. Lesion thickness was correlated with lesion SUV_max in FDG-avid lesions only. FDG arterial uptake was not associated with systemic inflammation or NIH criteria.

Conclusions

PET/CT reveals unique and fundamental features of arterial involvement in TA. PET/CT may be useful in the assessment of local inflammatory and vascular remodelling events independent of systemic inflammation during follow-up, even in lesions in which the arterial wall is <4 mm. The presence of arterial grafts is a potential confounder. Prospective studies are required to correlate PET findings with relevant clinical outcomes.

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Title: 18F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu’s arteritis
Authors: Elena Incerti
Enrico Tombetti
Federico Fallanca
Elena M. Baldissera
Pierpaolo Alongi
Elisabetta Tombolini
Silvia Sartorelli
Maria Grazia Sabbadini
Maurizio Papa
Francesco De Cobelli
Justin C. Mason
Luigi Gianolli
Angelo A. Manfredi
Maria Picchio
Publication date: 01-07-2017
Publisher: Springer Berlin Heidelberg
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 7/2017
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-017-3639-y

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Springer Medicine

¹⁸F-FDG PET reveals unique features of large vessel inflammation in patients with Takayasu’s arteritis

Abstract

Purpose

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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