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Diagnosis and follow up of aortitis in the elderly

A K Scheel1, J Meller, R Vosshenrich

  • 1Department of Medicine, Georg-August-University Göttingen, D-37075 Göttingen, Germany. ascheel@gwdg.de

Annals of the Rheumatic Diseases
|October 14, 2004
PubMed
Abstract

Insights

[(18)F]FDG-PET scans show decreasing inflammation in aortitis patients, correlating with clinical markers. MRI scans, while effective for initial detection, offer more static results during follow-up.

Area of Science:

  • Vascular Imaging
  • Nuclear Medicine
  • Radiology

Background:

  • Aortitis, a serious inflammatory condition affecting the aorta, requires accurate diagnostic and monitoring tools.
  • Giant cell arteritis (GCA)-like symptoms can present unspecifically, complicating diagnosis.
  • Distinguishing active inflammation from chronic changes is crucial for effective treatment.

Purpose of the Study:

  • To compare the efficacy of Fluorine-18-fluorodeoxyglucose Positron Emission Tomography ([(18)F]FDG-PET) and Magnetic Resonance Imaging (MRI) in evaluating aortitis.
  • To assess the correlation between imaging findings and clinical disease activity and inflammatory markers.
  • To determine the utility of these modalities in monitoring treatment response over time.

Main Methods:

  • Eight patients with suspected aortitis underwent both [(18)F]FDG-PET and MRI.
  • The aorta was segmented into three regions for localized inflammation assessment.
  • Patients were followed clinically and with laboratory tests during corticosteroid treatment.

Main Results:

  • [(18)F]FDG-PET detected inflammation in 20/24 regions, while MRI identified it in 15/21 regions at diagnosis.
  • Follow-up [(18)F]FDG-PET showed normalization in 55% of initially affected regions, closely mirroring clinical and laboratory improvements.
  • In contrast, MRI revealed persistent abnormalities in 14/15 initially affected regions, showing limited change.

Conclusions:

  • Both [(18)F]FDG-PET and MRI are valuable for initial aortitis detection and correlate with inflammatory markers.
  • [(18)F]FDG-PET is superior for monitoring treatment response, as decreased uptake reflects clinical and serological improvements.
  • MRI provides a more static view, making it less sensitive for assessing dynamic changes in inflammation during follow-up.

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