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Updated: May 30, 2026

A Methodological Approach to Non-invasive Assessments of Vascular Function and Morphology
Published on: February 7, 2015
[Disease activity assessment in large vessel vasculitis]
L Magnani1, A Versari, D Salvo
1Struttura Complessa di Reumatologia, Arcispedale S. Maria Nuova, Viale Risorgimento 80, Reggio Emilia, Italy.
Insights
Assessing large vessel vasculitis (LVV) disease activity is difficult. While clinical indices and inflammatory markers correlate, positron emission tomography (PET) may offer greater sensitivity for detecting LVV activity.
Area of Science:
- Rheumatology
- Nuclear Medicine
- Immunology
Background:
- Assessing disease activity in large vessel vasculitis (LVV) presents significant clinical challenges.
- Current methods rely on clinical indices and inflammatory markers, but their accuracy can be limited.
Purpose of the Study:
- To compare the efficacy of inflammatory markers, clinical indices (Indian Takayasu Activity Score [ITAS], Kerr/National Institute of Health [Kerr/NIH]), and 18F-Fluorodeoxyglucose (FDG) Positron Emission Tomography (PET) in assessing LVV disease activity.
Main Methods:
- Patients with LVV underwent assessment using ITAS, Kerr/NIH indices, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and FDG-PET scans.
- Interleukin-6 (IL-6) and its soluble receptor levels were also analyzed.
Main Results:
- FDG-PET results did not statistically correlate with ITAS or Kerr/NIH indices, showing increased uptake in patients with clinically inactive disease.
- Interleukin-6 and its soluble receptor levels also lacked statistical correlation with disease activity.
- Clinical indices (ITAS, Kerr/NIH) demonstrated significant correlation with each other and with inflammatory markers (ESR, CRP).
Conclusions:
- Clinical indices and inflammatory markers are valuable for assessing LVV disease activity.
- FDG-PET may be a more sensitive tool for detecting subclinical inflammation in LVV, despite a lack of correlation with current clinical scoring systems.
Abstract:
Disease activity assessment in large vessel vasculitis (LVV) is often challenging for physicians. In this study, we compared the assessment of disease activity based on inflammatory markers, clinical indices (Indian Takayasu Activity Score [ITAS] and the Kerr/National Institute of Health indices [Kerr/NIH]), and 18F-Fluorodesossiglucose (FGD) vascular uptake at positron emission tomography (Pet). We found that Pet results did not statistically correlate with the clinical indices ITAS and Kerr/NIH, because FDG uptake was increased (grade>2 on a 0-3 scale in at least one evaluated vascular segment) in many patients with inactive disease according to clinical and laboratory parameters (i.e., negative ITAS and Kerr/NIH indices as well as normal erythrocyte sedimentation rate (ESR) and C-reactive protein (PCR)). Similarly, interleukin- 6 and its soluble receptor did not statistically correlate with disease activity. In contrast, clinical indices showed a significant correlation between each other and with inflammatory markers (VES and PCR). These data suggest that while clinical indices and inflammatory markers may be useful to assess disease activity, Pet may be more sensitive.
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