![Quantification of Atherosclerotic Plaque Activity and Vascular Inflammation using [18-F] Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography FDG-PET/CT](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F3777.jpg&w=3840&q=50)
Prognostic Value of Cranial Arteries Involvement on 18 F-FDG PET/CT at Giant Cell Arteritis Diagnosis in a
Rachel Bardy1, Estelle Detournay2,3,4, Alexis F Guedon5
1Nantes Université, Univ Angers, CHU Nantes, INSERM, CNRS, CRCI2NA, Médecine Nucléaire, Nantes.
Background:
The aim of this study was to assess the prognostic value of 18 F-FDG PET/CT-based features performed at the diagnosis of giant cell arteritis (GCA) for the risk of relapse.
Patients And Methods:
18 F-FDG PET/CT was performed in patients with GCA between 2014 and 2024 before 10 days of corticosteroid therapy. Visual scores were assessed: TVS, PETVAS, "extended" PETVAS with 17 segments (PETVAS51), cephalic score "C-VAS" dedicated to the branches of the external carotid artery, and global score "G-VAS" combining all the previous territories. Maximum standardized uptake values (SUVmax) and target-to-background ratios (TBR) normalized to liver or circulating blood pool were also collected. Relapse was defined by the occurrence of suggestive clinical, biological, or imaging events. Survival analyses (Kaplan-Meier) and Cox models adjusted for age, sex, and camera type (analog or digital) were used to identify prognostic factors for relapse.
Results:
Seventy-six patients were included, 41% of them relapsed after a median follow-up of 14 months. None of the conventional scores (TVS, PETVAS, PETVAS 51) or semiquantitative parameters predicted relapse. In contrast, the G-VAS >45 and C-VAS >8 were significantly associated with relapse in univariate analysis [HR = 2.64 (95% CI: 1.00; 6.98), P = 0.043 and 3.48 (1.30; 9.29), P = 0.0084, respectively]. Only a C-VAS score >8 was an independent predictor of prompt relapses in multivariate analysis [HR = 3.31 (1.16-9.38)].
Conclusions:
In patients with GCA, increased uptake of the cephalic branches of the external carotid artery on initial 18 F-FDG PET/CT was an independent prognostic factor for relapse.
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