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Advances in PET Imaging of Large Vessel Vasculitis: An Update and Future Trends
Kornelis S M van der Geest1, Olivier Gheysens2, Lars C Gormsen3
1Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
Insights
Systemic vasculitides involve blood vessel inflammation. This review updates on positron emission tomography (PET) imaging advancements for diagnosing large-vessel vasculitis, including giant cell arteritis and Takayasu arteritis.
Area of Science:
- Immunology
- Radiology
- Rheumatology
Background:
- Systemic vasculitides are autoimmune diseases causing blood vessel inflammation.
- Classification is based on affected vessel size: large, medium, and small.
- Giant cell arteritis (GCA) and Takayasu arteritis (TAK) are primary large-vessel vasculitides.
Purpose of the Study:
- To provide an updated overview of positron emission tomography (PET) imaging in large vessel vasculitis.
- To highlight recent advancements in PET/CT technology and radiopharmaceuticals for vasculitis imaging.
Main Methods:
- Review of current imaging modalities for large vessel vasculitis, including ultrasonography, MRA, CTA, and FDG-PET/CT.
- Focus on advancements in PET imaging, such as digital PET/CT and novel radiopharmaceuticals.
- Discussion of complementary roles of various imaging techniques.
Main Results:
- Various imaging modalities offer complementary diagnostic information for large vessel vasculitis.
- Recent PET imaging advances include digital PET/CT, enhanced acquisition protocols, quantitative methods, and new radiotracers.
- These developments improve the assessment of vascular inflammation in conditions like GCA and TAK.
Conclusions:
- PET imaging plays a crucial role in diagnosing and monitoring large vessel vasculitis.
- Ongoing technological and radiopharmaceutical advancements are enhancing the capabilities of PET/CT in this field.
- Comprehensive imaging strategies are essential for effective management of vasculitis.
Abstract:
Systemic vasculitides are autoimmune diseases characterized by inflammation of blood vessels. They are categorized based on the size of the preferentially affected blood vessels: large-, medium-, and small-vessel vasculitides. The main forms of large-vessel vasculitis include giant cell arteritis (GCA) and Takayasu arteritis (TAK). Depending on the location of the affected vessels, various imaging modalities can be employed for diagnosis of large vessel vasculitis: ultrasonography (US), magnetic resonance angiography (MRA), computed tomography angiography (CTA), and [18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT). These imaging tools offer complementary information about vascular changes occurring in vasculitis. Recent advances in PET imaging in large vessel vasculitis include the introduction of digital long axial field-of-view PET/CT, dedicated acquisition, quantitative methodologies, and the availability of novel radiopharmaceuticals. This review aims to provide an update on the current status of PET imaging in large vessel vasculitis and to share the latest developments on imaging vasculitides.
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