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Published in: Clinical Rheumatology 7/2018

01-07-2018 | Original Article

18F-FDG-PET/CT: an accurate method to assess the activity of Takayasu’s arteritis

Authors: Xiaojie Zhang, Jun Zhou, Ying Sun, Hongcheng Shi, Zongfei Ji, Lindi Jiang

Published in: Clinical Rheumatology | Issue 7/2018

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Abstract

The objective of the study is to investigate the value of 18F-fluorodeoxyglucose–positron emission tomography/computed tomography (18F-FDG-PET/CT) for assessment of the activity of Takayasu’s arteritis (TA) and the correlation between acute-phase reactive proteins (ARPs) and standard uptake value (SUV). Analyses of the clinical characteristics and 42 18F-FDG-PET/CT scans in 39 TA patients were undertaken. The degree of FDG uptake in the blood vessel walls was assessed quantitatively by SUV. TA activity was analyzed by physician global assessment (PGA). Clinical and 18F-FDG-PET/CT characteristics were compared between patients with clinically active and clinically inactive TA. Maximum SUV (SUVmax), mean SUV (SUVmean), and SUV ratio (SUVratio) were significantly higher in the clinically active group than in the clinically inactive group (3.63 ± 1.96 vs. 1.82 ± 0.43, p = 0.007; 2.07 ± 0.71 vs. 1.43 ± 0.32, p = 0.009; 2.08 ± 1.17 vs. 0.95 ± 0.19, p = 0.000). Analyses of receiver operating characteristic (ROC) curves revealed a cutoff value of SUVmax of 2.21, with sensitivity and specificity of 86.2 and 90.0%, respectively, for clinically active TA. The SUVratio cutoff was 1.27 with a sensitivity and specificity of 79.3 and 100.0%, respectively. SUVratio was slightly superior to SUVmax and ARPs in the area under the curve (AUC) comparison. SUVmax and SUVratio showed a significant increasing trend with increasing US National Institutes of Health (NIH) score and levels of ARPs, interleukin-6, and serum amyloid-A protein. 18F-FDG-PET/CT is a promising non-invasive, quantitative measurement with high sensitivity and specificity for determining TA activity.
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Literature
1.
go back to reference Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, Ozer HT, Seyahi E, Akar S, Onen F, Cefle A, Aydin SZ, Yilmaz N, Onat AM, Cobankara V, Tunc E, Ozturk MA, Fresko I, Karaaslan Y, Akkoc N, Yucel AE, Kiraz S, Keser G, Inanc M, Direskeneli H (2009) Takayasu’s arteritis in Turkey—clinical and angiographic features of 248 patients. Clin Exp Rheumatol 27(1 Suppl 52):S59–S64PubMed Bicakcigil M, Aksu K, Kamali S, Ozbalkan Z, Ates A, Karadag O, Ozer HT, Seyahi E, Akar S, Onen F, Cefle A, Aydin SZ, Yilmaz N, Onat AM, Cobankara V, Tunc E, Ozturk MA, Fresko I, Karaaslan Y, Akkoc N, Yucel AE, Kiraz S, Keser G, Inanc M, Direskeneli H (2009) Takayasu’s arteritis in Turkey—clinical and angiographic features of 248 patients. Clin Exp Rheumatol 27(1 Suppl 52):S59–S64PubMed
4.
go back to reference Basu N, Watts R, Bajema I, Baslund B, Bley T, Boers M, Brogan P, Calabrese L, Cid MC, Cohen-Tervaert JW, Flores-Suarez LF, Fujimoto S, de Groot K, Guillevin L, Hatemi G, Hauser T, Jayne D, Jennette C, Kallenberg CG, Kobayashi S, Little MA, Mahr A, McLaren J, Merkel PA, Ozen S, Puechal X, Rasmussen N, Salama A, Salvarani C, Savage C, Scott DG, Segelmark M, Specks U, Sunderkoetter C, Suzuki K, Tesar V, Wiik A, Yazici H, Luqmani R (2010) EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis. Ann Rheum Dis 69(10):1744–1750. https://doi.org/10.1136/ard.2009.119032 CrossRefPubMed Basu N, Watts R, Bajema I, Baslund B, Bley T, Boers M, Brogan P, Calabrese L, Cid MC, Cohen-Tervaert JW, Flores-Suarez LF, Fujimoto S, de Groot K, Guillevin L, Hatemi G, Hauser T, Jayne D, Jennette C, Kallenberg CG, Kobayashi S, Little MA, Mahr A, McLaren J, Merkel PA, Ozen S, Puechal X, Rasmussen N, Salama A, Salvarani C, Savage C, Scott DG, Segelmark M, Specks U, Sunderkoetter C, Suzuki K, Tesar V, Wiik A, Yazici H, Luqmani R (2010) EULAR points to consider in the development of classification and diagnostic criteria in systemic vasculitis. Ann Rheum Dis 69(10):1744–1750. https://​doi.​org/​10.​1136/​ard.​2009.​119032 CrossRefPubMed
5.
go back to reference Yadav MK (2007) Takayasu arteritis: clinical and CT-angiography profile of 25 patients and a brief review of literature. Indian Heart J 59(6):468–474PubMed Yadav MK (2007) Takayasu arteritis: clinical and CT-angiography profile of 25 patients and a brief review of literature. Indian Heart J 59(6):468–474PubMed
7.
go back to reference Germano G, Monti S, Ponte C, Possemato N, Caporali R, Salvarani C, Macchioni P, Pipitone N (2017) The role of ultrasound in the diagnosis and follow-up of large-vessel vasculitis: an update. Clin Exp Rheumatol 103(1):194–198 Germano G, Monti S, Ponte C, Possemato N, Caporali R, Salvarani C, Macchioni P, Pipitone N (2017) The role of ultrasound in the diagnosis and follow-up of large-vessel vasculitis: an update. Clin Exp Rheumatol 103(1):194–198
8.
go back to reference Cavo M, Terpos E, Nanni C, Moreau P, Lentzsch S, Zweegman S, Hillengass J, Engelhardt M, Usmani SZ, Vesole DH, San-Miguel J, Kumar SK, Richardson PG, Mikhael JR, da Costa FL, Dimopoulos MA, Zingaretti C, Abildgaard N, Goldschmidt H, Orlowski RZ, Chng WJ, Einsele H, Lonial S, Barlogie B, Anderson KC, Rajkumar SV, Durie BGM, Zamagni E (2017) Role of 18F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group. Lancet Oncol 18(4):e206–e217. https://doi.org/10.1016/S1470-2045(17)30189-4 CrossRefPubMed Cavo M, Terpos E, Nanni C, Moreau P, Lentzsch S, Zweegman S, Hillengass J, Engelhardt M, Usmani SZ, Vesole DH, San-Miguel J, Kumar SK, Richardson PG, Mikhael JR, da Costa FL, Dimopoulos MA, Zingaretti C, Abildgaard N, Goldschmidt H, Orlowski RZ, Chng WJ, Einsele H, Lonial S, Barlogie B, Anderson KC, Rajkumar SV, Durie BGM, Zamagni E (2017) Role of 18F-FDG PET/CT in the diagnosis and management of multiple myeloma and other plasma cell disorders: a consensus statement by the International Myeloma Working Group. Lancet Oncol 18(4):e206–e217. https://​doi.​org/​10.​1016/​S1470-2045(17)30189-4 CrossRefPubMed
11.
go back to reference Ishimori T, Saga T, Mamede M, Kobayashi H, Higashi T, Nakamoto Y, Sato N, Konishi J (2002) Increased (18)F-FDG uptake in a model of inflammation: concanavalin A-mediated lymphocyte activation. J Nucl Med : Off Publ Soc Nucl Med 43(5):658–663 Ishimori T, Saga T, Mamede M, Kobayashi H, Higashi T, Nakamoto Y, Sato N, Konishi J (2002) Increased (18)F-FDG uptake in a model of inflammation: concanavalin A-mediated lymphocyte activation. J Nucl Med : Off Publ Soc Nucl Med 43(5):658–663
12.
go back to reference Kobayashi Y, Ishii K, Oda K, Nariai T, Tanaka Y, Ishiwata K, Numano F (2005) Aortic wall inflammation due to Takayasu arteritis imaged with 18F-FDG PET coregistered with enhanced CT. J Nucl Med : Off Publ Soc Nucl Med 46(6):917–922 Kobayashi Y, Ishii K, Oda K, Nariai T, Tanaka Y, Ishiwata K, Numano F (2005) Aortic wall inflammation due to Takayasu arteritis imaged with 18F-FDG PET coregistered with enhanced CT. J Nucl Med : Off Publ Soc Nucl Med 46(6):917–922
14.
go back to reference Arnaud L, Haroche J, Malek Z, Archambaud F, Gambotti L, Grimon G, Kas A, Costedoat-Chalumeau N, Cacoub P, Toledano D, Cluzel P, Piette JC, Amoura Z (2009) Is (18)F-fluorodeoxyglucose positron emission tomography scanning a reliable way to assess disease activity in Takayasu arteritis? Arthritis Rheum 60(4):1193–1200. https://doi.org/10.1002/art.24416 CrossRefPubMed Arnaud L, Haroche J, Malek Z, Archambaud F, Gambotti L, Grimon G, Kas A, Costedoat-Chalumeau N, Cacoub P, Toledano D, Cluzel P, Piette JC, Amoura Z (2009) Is (18)F-fluorodeoxyglucose positron emission tomography scanning a reliable way to assess disease activity in Takayasu arteritis? Arthritis Rheum 60(4):1193–1200. https://​doi.​org/​10.​1002/​art.​24416 CrossRefPubMed
15.
go back to reference Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW Jr et al (1990) The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33(8):1129–1134CrossRefPubMed Arend WP, Michel BA, Bloch DA, Hunder GG, Calabrese LH, Edworthy SM, Fauci AS, Leavitt RY, Lie JT, Lightfoot RW Jr et al (1990) The American College of Rheumatology 1990 criteria for the classification of Takayasu arteritis. Arthritis Rheum 33(8):1129–1134CrossRefPubMed
20.
go back to reference de Leeuw K, Bijl M, Jager PL (2004) Additional value of positron emission tomography in diagnosis and follow-up of patients with large vessel vasculitides. Clin Exp Rheumatol 22(6 Suppl 36):S21–S26PubMed de Leeuw K, Bijl M, Jager PL (2004) Additional value of positron emission tomography in diagnosis and follow-up of patients with large vessel vasculitides. Clin Exp Rheumatol 22(6 Suppl 36):S21–S26PubMed
23.
go back to reference Hoffman GS, Ahmed AE (1998) Surrogate markers of disease activity in patients with Takayasu arteritis. A preliminary report from The International Network for the Study of the Systemic Vasculitides (INSSYS). Int J Cardiol 66(Suppl 1):S191–S194 discussion S195CrossRefPubMed Hoffman GS, Ahmed AE (1998) Surrogate markers of disease activity in patients with Takayasu arteritis. A preliminary report from The International Network for the Study of the Systemic Vasculitides (INSSYS). Int J Cardiol 66(Suppl 1):S191–S194 discussion S195CrossRefPubMed
26.
go back to reference Henes JC, Muller M, Krieger J, Balletshofer B, Pfannenberg AC, Kanz L, Kotter I (2008) [18F] FDG-PET/CT as a new and sensitive imaging method for the diagnosis of large vessel vasculitis. Clin Exp Rheumatol 26(3 Suppl 49):S47–S52PubMed Henes JC, Muller M, Krieger J, Balletshofer B, Pfannenberg AC, Kanz L, Kotter I (2008) [18F] FDG-PET/CT as a new and sensitive imaging method for the diagnosis of large vessel vasculitis. Clin Exp Rheumatol 26(3 Suppl 49):S47–S52PubMed
28.
29.
go back to reference Karapolat I, Kalfa M, Keser G, Yalcin M, Inal V, Kumanlioglu K, Pirildar T, Aksu K (2013) Comparison of F18-FDG PET/CT findings with current clinical disease status in patients with Takayasu’s arteritis. Clin Exp Rheumatol 31(1 Suppl 75):S15–S21PubMed Karapolat I, Kalfa M, Keser G, Yalcin M, Inal V, Kumanlioglu K, Pirildar T, Aksu K (2013) Comparison of F18-FDG PET/CT findings with current clinical disease status in patients with Takayasu’s arteritis. Clin Exp Rheumatol 31(1 Suppl 75):S15–S21PubMed
32.
go back to reference Kong X, Sun Y, Ma L, Chen H, Wei L, Wu W, Ji Z, Ma L, Zhang Z, Zhang Z, Zhao Z, Hou J, Dai S, Yang C, Jiang L (2016) The critical role of IL-6 in the pathogenesis of Takayasu arteritis. Clin Exp Rheumatol 34(3 Suppl 97):S21–S27PubMed Kong X, Sun Y, Ma L, Chen H, Wei L, Wu W, Ji Z, Ma L, Zhang Z, Zhang Z, Zhao Z, Hou J, Dai S, Yang C, Jiang L (2016) The critical role of IL-6 in the pathogenesis of Takayasu arteritis. Clin Exp Rheumatol 34(3 Suppl 97):S21–S27PubMed
Metadata
Title
18F-FDG-PET/CT: an accurate method to assess the activity of Takayasu’s arteritis
Authors
Xiaojie Zhang
Jun Zhou
Ying Sun
Hongcheng Shi
Zongfei Ji
Lindi Jiang
Publication date
01-07-2018
Publisher
Springer London
Published in
Clinical Rheumatology / Issue 7/2018
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-017-3960-7

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