PET/CT in inflammatory joint disorders: update and future trends.
François Jamar1, Wouter R P van der Heijden2, Conny J van der Laken2
1Department of Nuclear Medicine, Cliniques universitaires St-Luc and Institute for Experimental and Clinical Research (IREC), Université Catholique de Louvain, Brussels, Belgium.
Seminars in Nuclear Medicine
|April 5, 2026
Summary
Functional imaging like PET/CT aids diagnosis of inflammatory joint disorders. Newer tracers offer improved specificity over [18F]-FDG PET/CT for conditions like rheumatoid arthritis and polymyalgia rheumatica.
Area of Science:
- Nuclear Medicine
- Radiology
- Rheumatology
Background:
- Inflammatory joint disorders are common, causing significant patient burden and healthcare costs.
- Clinical evaluation is primary, but advanced imaging aids diagnosis and treatment monitoring.
- Functional imaging, particularly PET/CT, offers high sensitivity for detecting disease, even when subclinical.
Purpose of the Study:
- To review the role of functional imaging, specifically PET/CT, in assessing inflammatory joint disorders.
- To discuss the limitations of [18F]-FDG PET/CT and introduce novel PET tracers.
- To highlight the utility of different tracers based on the underlying pathophysiology of specific arthropathies.
Main Methods:
- Review of current literature on PET/CT applications in rheumatology.
- Discussion of [18F]-FDG PET/CT and its use in conditions like rheumatoid arthritis.
- Introduction of novel PET tracers targeting macrophages (TSPO, folate receptors) and FAPIs.
- Consideration of bone-seeking tracers (e.g., 18F-sodium fluoride) for disorders with bone remodeling.
Main Results:
- [18F]-FDG PET/CT is a sensitive tool for inflammatory arthritis but lacks specificity.
- Emerging tracers targeting TSPO, folate receptors, and FAPIs show promise for improved specificity.
- Bone-seeking tracers are more effective for spondyloarthropathies and psoriatic arthritis due to bone remodeling.
Conclusions:
- PET/CT is valuable for assessing inflammatory joint diseases, guiding therapy, and monitoring treatment response.
- Novel PET tracers are being developed to overcome the specificity limitations of [18F]-FDG.
- The choice of PET tracer should be tailored to the specific joint disorder's characteristics, such as inflammation versus bone remodeling.
Related Concept Videos
01:30Inflammatory Bowel Disease II: Crohn's Disease
1.5K
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
1.5K
01:29Inflammatory Bowel Disease IV: Pharmacological Management
955
Upon diagnosis, managing Inflammatory Bowel Disease (IBD) involves addressing several crucial aspects. The primary goals include resting the bowel, correcting malnutrition, and providing symptomatic relief. Resting the bowel may consist of medications to reduce inflammation and promote healing. Correcting malnutrition is essential, often requiring dietary adjustments and nutritional supplements. Symptomatic relief aims to ease pain, diarrhea, and other discomforts in IBD.
Pharmacologic...
Pharmacologic...
955
01:24Drugs for Treatment of Crohn's Disease in IBD Using Biologic Agents: Anti-TNF
764
Tumor Necrosis Factor (TNF), a proinflammatory cytokine, contributes significantly to the inflammation seen in Crohn's disease. It exists as soluble TNF and membrane-bound TNF, with actions mediated through TNF receptors (TNFR). TNFR activation leads to the release of proinflammatory cytokines, T-cell activation, collagen production, and leukocyte migration, all contributing to inflammation in Crohn's disease. Anti-TNF monoclonal antibodies, namely infliximab (Remicade), adalimumab...
764