[18F]FDG PET/CT in rheumatoid arthritis

Area of Science:

• Nuclear Medicine
• Rheumatology
• Radiochemistry

Background:

• Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting joints.
• Current assessment methods for RA can be limited in evaluating disease activity and complications.
• Positron emission tomography (PET) imaging offers advanced visualization of biological processes.

Purpose of the Study:

• To explore the utility of [¹⁸F]fluorodeoxyglucose (FDG) PET/CT in assessing RA inflammation and response.
• To investigate the role of Fluorine-18-labeled Sodium fluoride (NaF) PET/CT in evaluating synovial osteoblastic activity and calcification in RA.
• To discuss the potential of PET/CT in managing RA complications like vasculitis and malignancy.

Main Methods:

• Utilizing [¹⁸F]FDG PET/CT to visualize and quantify synovial metabolic activity.
• Employing NaF PET/CT to assess synovial osteoblastic activity and aortic calcification.
• Reviewing the application of these PET tracers in RA disease severity assessment and differential diagnosis.

Main Results:

• [¹⁸F]FDG PET/CT effectively images inflammation in RA, with standard uptake values correlating with synovial activity.
• NaF PET/CT can determine synovial osteoblastic activity and is useful for studying aortic calcification in RA patients.
• FDG PET/CT is emerging as a tool for response assessment in RA, similar to its role in cancer management.
• PET/CT can aid in excluding malignancy when RA presentation is atypical.
• Novel tracers are under investigation for RA, with potential theranostic applications.

Conclusions:

• [¹⁸F]FDG and NaF PET/CT are valuable tools for evaluating inflammation, osteoblastic activity, and complications in rheumatoid arthritis.
• These imaging techniques show potential for assessing disease severity, treatment response, and aiding in differential diagnosis.
• Future research into novel PET tracers may further enhance the management of RA.