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Annals of Nuclear Medicine

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01-07-2016 | Original Article

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

Authors: Massimo Castellani, Manuela Vadrucci, Luigia Florimonte, Monica Caronni, Riccardo Benti, Paola Bonara

Published in: Annals of Nuclear Medicine | Issue 6/2016

Abstract

Objective

Over the last decade, the contribution of ¹⁸F-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

¹⁸F-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.

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Title: 18F-FDG uptake in main arterial branches of patients with large vessel vasculitis: visual and semiquantitative analysis
Authors: Massimo Castellani
Manuela Vadrucci
Luigia Florimonte
Monica Caronni
Riccardo Benti
Paola Bonara
Publication date: 01-07-2016
Publisher: Springer Japan
Published in: Annals of Nuclear Medicine / Issue 6/2016
Print ISSN: 0914-7187
Electronic ISSN: 1864-6433
DOI: https://doi.org/10.1007/s12149-016-1075-x

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Springer Medicine

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

Abstract

Objective

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Objective

Methods

Results

Conclusions

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