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Total-Body 18F-FDG PET/CT in Autoimmune Inflammatory Arthritis at Ultra-Low Dose: Initial Observations
Yasser Abdelhafez1,2, Siba P Raychaudhuri3,4, Dario Mazza1
1Department of Radiology, University of California Davis, Davis, California.
Total-body (TB) PET/CT imaging with an ultra-low-dose protocol effectively evaluates systemic joint involvement in autoimmune inflammatory arthritides (AIA). This advanced imaging correlates well with rheumatologic assessments, offering a promising tool for AIA patient management.
Area of Science:
- Nuclear Medicine
- Radiology
- Rheumatology
Background:
- Autoimmune inflammatory arthritides (AIA), including psoriatic arthritis and rheumatoid arthritis, are chronic systemic diseases impacting multiple joints.
- Conventional PET/CT systems have limitations in evaluating the full extent of systemic joint involvement in AIA.
- Emerging total-body (TB) PET/CT scanners offer enhanced capabilities for comprehensive body imaging.
Purpose of the Study:
- To assess the performance of an ultra-low-dose 18F-FDG TB PET/CT protocol for evaluating systemic joint involvement in AIA.
- To compare TB PET/CT findings with joint-by-joint rheumatologic examinations and standardized outcome measures.
- To investigate the association between TB PET/CT quantitative measures and rheumatologic assessments in AIA.
Main Methods:
- Prospective observational study involving 30 participants (24 with AIA, 6 with osteoarthritis).
- All participants underwent a 20-minute ultra-low-dose 18F-FDG TB PET/CT scan after intravenous injection.
- Qualitative and quantitative analyses of 18F-FDG uptake were performed and compared with rheumatologic assessments.
Main Results:
- TB PET/CT successfully visualized 18F-FDG uptake in joints throughout the entire body in a single acquisition.
- Concordance between TB PET qualitative assessment and rheumatologic evaluation was observed in 69.9% of AIA joints.
- Quantitative TB PET measures showed moderate-to-strong correlations with rheumatologic outcome measures in the AIA cohort (Spearman ρ = 0.53–0.70, P < 0.05).
Conclusions:
- Systemic joint evaluation in autoimmune inflammatory arthritides (and non-AIA conditions) is feasible using an ultra-low-dose TB PET/CT protocol.
- TB PET/CT imaging demonstrates potential for improved assessment of joint involvement in AIA.
- These findings support further research with larger cohorts to validate TB PET/CT technology for AIA joint assessment.
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