Highlights
- •Evolution under treatment of large-vessel uptakes on repetitive PET/CT is unknown.
- •<20% of patients had total extinction of vascular uptakes under treatment.
- •PET/CT results did not influence therapeutic management in controlled disease.
Abstract
Objective
18F-FDG PET/CT can detect large-vessel involvement in giant-cell arteritis (GCA) with
a good sensitivity. In patients with clinically and biologically controlled disease,
we aimed to assess how vascular uptakes evolve on repetitive FDG-PET/CT.
Patients and methods
All included patients had to satisfy the 4 following criteria: 1) diagnosis of GCA
was retained according to the criteria of the American College of Rheumatology or
based on the satisfaction of 2 criteria associated with the demonstration of large-vessel
involvement on FDG-PET/CT; 2) all patients had a positive PET/CT that was performed
at diagnosis before treatment or within the first 10 days of treatment; 3) another FDG-PET/CT was performed after at least 3 months of controlled disease without any relapse; 4) patients were followed-up at
least for 12 months.
Results
Twenty-five patients (17 [68%] women, median age: 69 [65–78]) with large-vessel inflammation
on a baseline FDG-PET/CT and with repetitive imaging during the period with controlled
disease were included and followed-up for 62 [25–95] months. Four repeated procedures
revealed total extinction of vascular uptakes at 11.5 [8–12] months after the first
FDG-PET/CT. Eight PET/CT revealed decreased numbers of vascular uptakes, and 10 procedures
revealed no changes. The 3 remaining procedures indicated worsening of the numbers
of vascular uptakes in the absence of relapse.
Conclusions
Our study revealed long-term persistent vascular uptake on repeated FDG-PET/CT in
>80% of our GCA patients with large-vessel inflammation and clinical-biological controlled
disease. Prospective studies are required to confirm these findings.
Abbreviations:
CRP (C-reactive protein), DMARDs (disease-modifying antirheumatic drugs), FDG-PET/CT (positron emission tomography with 18F-fluorodeoxyglucose (FDG) combined with computed tomography (PET/CT)), GC (glucocorticoids), GCA (giant-cell arteritis), TAB (temporal artery biopsy)Keywords
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Article info
Publication history
Published online: August 30, 2017
Accepted:
August 13,
2017
Received in revised form:
July 20,
2017
Received:
February 20,
2017
Identification
Copyright
© 2017 European Federation of Internal Medicine. Published by Elsevier B.V. All rights reserved.
