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18F-FDG PET/CT in patients with polymyositis/dermatomyositis: correlation with serum muscle enzymes
Hanae Arai-Okuda1, Takashi Norikane1, Yuka Yamamoto2
1Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Background:
Muscle enzymes are the major noninvasive diagnostic parameters useful in polymyositis/dermatomyositis (PM/DM). Few studies have yet correlated findings on 18F-FDG PET with disease activity in patients with PM/DM.
Purpose:
We evaluated 18F-FDG muscle uptake in patients with PM/DM compared with non-muscular diseases and correlated the results with serum muscle enzymes.
Methods:
A total of 28 patients with untreated PM/DM and 28 control patients with non-muscular diseases were examined with 18F-FDG PET/CT. 18F-FDG uptake was evaluated in 9 proximal skeletal muscle regions bilaterally. The uptake was scored as follows: 0 = less than that of the mediastinal blood vessels, 1 = greater than or equal to that of the mediastinal blood vessels, and 2 = greater than or equal to that of the liver. A score 1 or 2 was considered positive. The mean and maximum standardized uptake values (SUV) were calculated in each muscle and were averaged for all muscle regions. PET findings were correlated with serum muscle enzymes.
Results:
18F-FDG uptake was observed in 82% of patients with PM/DM and 7% of control patients. The number of positive regions, total score, mean SUVmean, and mean SUVmax in patients with PM/DM were significantly higher than those in the control patients (all P < 0.001). The total score of 2 was the best cut-off value that could discriminate patients with PM/DM from control patients. The total score, mean SUVmean, and mean SUVmax showed significant correlations with creatine kinase (P = 0.047, 0.002, 0.010, respectively) and aldolase (P = 0.036, 0.005, 0.038, respectively).
Conclusion:
18F-FDG PET/CT using visual and SUV methods demonstrated its usefulness by discriminating PM/DM from non-muscular diseases and correlating with serum muscle enzymes in patients with PM/DM.
Insights
18F-FDG PET/CT effectively distinguishes polymyositis/dermatomyositis (PM/DM) from other conditions. This imaging technique shows significant correlation with key muscle enzymes, aiding in PM/DM diagnosis and activity assessment.
Area of Science:
- Nuclear Medicine
- Radiology
- Rheumatology
Background:
- Polymyositis/dermatomyositis (PM/DM) diagnosis relies heavily on muscle enzymes.
- Limited research exists on correlating 18F-FDG PET findings with PM/DM disease activity.
- 18F-FDG PET offers a noninvasive imaging approach to assess muscle inflammation.
Purpose of the Study:
- To evaluate 18F-FDG muscle uptake in patients with PM/DM.
- To compare 18F-FDG uptake in PM/DM patients versus those with non-muscular diseases.
- To correlate 18F-FDG PET findings with serum muscle enzyme levels.
Main Methods:
- 28 untreated PM/DM patients and 28 controls underwent 18F-FDG PET/CT.
- 18F-FDG uptake was assessed in 9 proximal skeletal muscle regions bilaterally using a visual scoring system (0-2).
- Mean and maximum standardized uptake values (SUV) were calculated and correlated with serum creatine kinase and aldolase.
Main Results:
- 18F-FDG uptake was significantly higher in PM/DM patients (82%) compared to controls (7%).
- Total score, mean SUVmean, and mean SUVmax were significantly elevated in PM/DM patients (P < 0.001).
- Total score, mean SUVmean, and mean SUVmax demonstrated significant correlations with creatine kinase and aldolase levels.
Conclusions:
- 18F-FDG PET/CT is a valuable tool for differentiating PM/DM from non-muscular diseases.
- The imaging technique shows significant correlation with serum muscle enzyme levels.
- 18F-FDG PET/CT aids in assessing disease activity and diagnosis in PM/DM.
