Medium-Vessel Vasculitis on FDG-PET/CT at Initial Presentation and Relapse

Area of Science:

• Medical Imaging
• Rheumatology
• Immunology

Background:

• Medium-vessel vasculitis is challenging to diagnose.
• Clinical presentation can be varied and non-specific.
• Early diagnosis and treatment are crucial for patient outcomes.

Purpose of the Study:

• To illustrate the diagnostic utility of FDG-PET/CT in medium-vessel vasculitis.
• To demonstrate the correlation between FDG-PET/CT findings and clinical symptoms.
• To highlight FDG-PET/CT's role in detecting disease relapse.

Main Methods:

• Case report of a 76-year-old male patient.
• Utilized contrast-enhanced CT and FDG-PET/CT for diagnosis.
• Monitored disease activity through clinical symptoms and serial FDG-PET/CT scans.
• Assessed treatment response with methotrexate and corticosteroids.

Main Results:

• Initial CT was inconclusive.
• FDG-PET/CT revealed pathological uptake in medium vessels, aiding diagnosis of vasculitis.
• Symptoms resolved with immunosuppressive therapy.
• A second FDG-PET/CT confirmed relapse with extensive uptake in limb arteries during corticosteroid tapering.

Conclusions:

• FDG-PET/CT is a valuable tool for diagnosing medium-vessel vasculitis.
• FDG-PET/CT findings correlate well with clinical manifestations.
• FDG-PET/CT can effectively detect disease relapse in medium-vessel vasculitis.