![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Repetitive 18F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease
Hubert de Boysson1, Nicolas Aide2, Eric Liozon3
1Department of Internal Medicine, Caen University Hospital, France; University of Caen - Basse Normandie, Caen, France.
Insights
Persistent vascular uptake on repeated 18F-FDG PET/CT is common in giant-cell arteritis (GCA) patients, even with controlled disease. This finding suggests ongoing inflammation despite clinical stability, warranting further investigation.
Area of Science:
- Nuclear Medicine
- Rheumatology
- Vascular Imaging
Background:
- 18F-FDG PET/CT is effective in detecting large-vessel involvement in giant-cell arteritis (GCA).
- The evolution of vascular uptake in GCA patients with controlled disease requires further study.
Purpose of the Study:
- To assess the changes in vascular uptakes on serial 18F-FDG PET/CT scans in patients with clinically and biologically controlled GCA.
Main Methods:
- Included 25 GCA patients with positive baseline PET/CT and at least one follow-up scan after 3 months of controlled disease.
- Patients were followed for a median of 62 months, with repetitive imaging performed during periods of disease control.
Main Results:
- Long-term persistent vascular uptake was observed on repeated 18F-FDG PET/CT in over 80% of GCA patients.
- While four patients showed complete resolution of uptake, others demonstrated decreased, unchanged, or even worsening vascular uptake despite clinical and biological control.
Conclusions:
- Repeated 18F-FDG PET/CT indicates persistent vascular inflammation in a majority of GCA patients, even when the disease is clinically and biologically controlled.
- Prospective studies are needed to validate these findings and understand their clinical implications.
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 10days of treatment; 3) another FDG-PET/CT was performed after at least 3months of controlled disease without any relapse; 4) patients were followed-up at least for 12months.
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.
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