![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)
Diagnostic performance of [18F]FDG PET/CT in large vessel vasculitis management: an umbrella review
Maria Del Grande1, Chiara Martinello2, Giorgio Treglia2,3,4
1Department of Rheumatology, University Hospital Basel, Basel, Switzerland - maria.delgrande@usb.ch.
Insights
[18F]FDG PET/CT is a highly accurate, non-invasive tool for diagnosing large vessel vasculitis (LVV), including giant cell arteritis (GCA) and Takayasu arteritis (TAK). This imaging technique shows promise in monitoring treatment effectiveness for LVV.
Area of Science:
- Nuclear medicine
- Radiology
- Rheumatology
Background:
- Large vessel vasculitis (LVV), including GCA, TAK, and PMR, causes significant morbidity by affecting large arteries.
- Accurate diagnosis of LVV is challenging with conventional methods like biopsy or CT/MRI.
- [18F]FDG PET/CT offers a non-invasive approach to assess arterial inflammation in LVV.
Purpose of the Study:
- To evaluate the diagnostic performance of [18F]FDG PET/CT in managing large vessel vasculitis (LVV).
- To assess the utility of [18F]FDG PET/CT in identifying active inflammation in LVV patients.
Main Methods:
- An umbrella review of systematic reviews and meta-analyses was conducted.
- Searches were performed in major databases (PubMed/MEDLINE, Embase, Cochrane, Scopus, Web of Science) up to February 2025.
- Data extraction and quality assessment followed the Oxford Center for Evidence-Based Medicine criteria.
Main Results:
- Thirteen systematic reviews confirmed [18F]FDG PET/CT's high sensitivity (75.9-90%) and specificity (71-98%) for active LVV detection.
- The technique demonstrated superior performance over CT/MRI in identifying extracranial inflammation, particularly in GCA and TAK.
- [18F]FDG PET/CT showed potential for monitoring treatment response in LVV.
Conclusions:
- [18F]FDG PET/CT is a valuable diagnostic tool for LVV, offering high accuracy and clinical utility.
- Emerging technologies like LAFOV scanners, novel radiotracers, and advanced MRI techniques are advancing diagnostic precision.
- Standardized protocols are needed for optimal integration of [18F]FDG PET/CT into clinical practice for LVV management.
Background:
Large vessel vasculitis (LVV), encompassing giant cell arteritis (GCA), Takayasu arteritis (TAK) and polymyalgia rheumatica (PMR), is a significant cause of morbidity due to its inflammatory effects on large arteries. Accurate diagnosis is critical but challenging with conventional methods like biopsy or CT/MRI. This umbrella review evaluates the diagnostic performance of [18F]FDG PET/CT, a non-invasive imaging tool for assessing inflammation, in LVV management.
Methods:
A comprehensive search was conducted in PubMed/MEDLINE, Embase, Cochrane Library, Scopus, and Web of Science for systematic reviews and meta-analyses published up to February 2025, addressing the research question: "What is the role of [18F]FDG PET/CT in large vessel vasculitis?". Data extraction and quality assessment were performed independently by two reviewers using the Oxford Center for Evidence-Based Medicine criteria.
Results:
Thirteen systematic reviews met the inclusion criteria, demonstrating high sensitivity (75.9-90%) and specificity (71-98%) of [18F]FDG PET/CT in detecting active LVV, particularly in GCA and TAK. It outperformed CT/MRI in identifying extracranial inflammation and showed promise in treatment monitoring.
Conclusions:
[18F]FDG PET/CT is a valuable tool for LVV diagnosis, offering high accuracy and clinical utility. However, emerging technologies such as LAFOV scanners and novel radiotracers, along with advancements in MRI techniques for intracranial assessment, define the new frontiers of diagnostic precision. Its integration into practice may enhance diagnostic precision and treatment strategies, though standardized protocols are needed.
More Related Videos
10:04Analysis of 18FDG PET/CT Imaging as a Tool for Studying Mycobacterium tuberculosis Infection and Treatment in Non-human Primates
Published on: September 5, 2017
10:28Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Related Concept Videos
01:13Radiological Investigation III: Pulmonary Angiogram and PET Scan
Pulmonary Angiogram
A Pulmonary Angiogram is an invasive procedure involving injecting a contrast medium through a catheter threaded into the pulmonary artery or the right side of the heart to visualize the pulmonary vasculature. Computed Tomography (CT) scans have mainly replaced this...
01:28Imaging Studies for Cardiovascular System V: CT