L Dellavedova1,2, M Carletto1, P Faggioli3, A Sciascera3, A Del Sole2, A Mazzone3, L S Maffioli4. 1. PET/CT Center - Nuclear Medicine Department, Ospedale Civile di Legnano, Via Papa Giovanni Paolo II, 1, 20025, Legnano (MI), Italy. 2. Department of Health Sciences, University of Milan, Milan, Italy. 3. Internal Medicine Department, Ospedale Civile di Legnano, Legnano, Italy. 4. PET/CT Center - Nuclear Medicine Department, Ospedale Civile di Legnano, Via Papa Giovanni Paolo II, 1, 20025, Legnano (MI), Italy. lsmaffioli@yahoo.com.
Abstract
PURPOSE: The aim of this study was to analyse if the result of a baseline (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, in large-vessel vasculitis (LVV) patients, is able to predict the course of the disease, not only in terms of presence/absence of final complications but also in terms of favourable/complicated progress (response to steroid therapy, time to steroid suspension, relapses, etc.). METHODS: A total of 46 consecutive patients, who underwent (18)F-FDG PET/CT between May 2010 and March 2013 for fever of unknown origin (FUO) or suspected vasculitis (before starting corticosteroid therapy), were enrolled. The diagnosis of LVV was confirmed in 17 patients. Considering follow-up results, positive LVV patients were divided into two groups, one characterized by favourable (nine) and the other by complicated progress (eight), on the basis of presence/absence of vascular complications, presence/absence of at least another positive PET/CT during follow-up and impossibility to comply with the tapering schedule of the steroid due to biochemical/symptomatic relapse. Vessel uptake in subjects of the two groups was compared in terms of intensity and extension. To evaluate the extent of active disease, we introduced two volume-based parameters: "volume of increased uptake" (VIU) and "total lesion glycolysis" (TLG). The threshold used to calculate VIU on vessel walls was obtained by the "vessel to liver" ratio by means of receiver-operating characteristic analysis and was set at 0.92 × liver maximum standardized uptake value in each patient. RESULTS: Measures of tracer uptake intensity were significantly higher in patients with complicated progress compared to those with a favourable one (p < 0.05). Measures of disease extension were even more significant and TLG emerged as the best parameter to separate the two groups of patients (p = 0.01). CONCLUSION: This pilot study shows that, in LVV patients, the combined evaluation of the intensity and the extension of FDG vessel uptake at diagnosis can predict the clinical course of the disease, separating patients with favourable or complicated progress.
PURPOSE: The aim of this study was to analyse if the result of a baseline (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, in large-vessel vasculitis (LVV) patients, is able to predict the course of the disease, not only in terms of presence/absence of final complications but also in terms of favourable/complicated progress (response to steroid therapy, time to steroid suspension, relapses, etc.). METHODS: A total of 46 consecutive patients, who underwent (18)F-FDG PET/CT between May 2010 and March 2013 for fever of unknown origin (FUO) or suspected vasculitis (before starting corticosteroid therapy), were enrolled. The diagnosis of LVV was confirmed in 17 patients. Considering follow-up results, positive LVV patients were divided into two groups, one characterized by favourable (nine) and the other by complicated progress (eight), on the basis of presence/absence of vascular complications, presence/absence of at least another positive PET/CT during follow-up and impossibility to comply with the tapering schedule of the steroid due to biochemical/symptomatic relapse. Vessel uptake in subjects of the two groups was compared in terms of intensity and extension. To evaluate the extent of active disease, we introduced two volume-based parameters: "volume of increased uptake" (VIU) and "total lesion glycolysis" (TLG). The threshold used to calculate VIU on vessel walls was obtained by the "vessel to liver" ratio by means of receiver-operating characteristic analysis and was set at 0.92 × liver maximum standardized uptake value in each patient. RESULTS: Measures of tracer uptake intensity were significantly higher in patients with complicated progress compared to those with a favourable one (p < 0.05). Measures of disease extension were even more significant and TLG emerged as the best parameter to separate the two groups of patients (p = 0.01). CONCLUSION: This pilot study shows that, in LVV patients, the combined evaluation of the intensity and the extension of FDG vessel uptake at diagnosis can predict the clinical course of the disease, separating patients with favourable or complicated progress.
Authors: J Meller; F Strutz; U Siefker; A Scheel; C O Sahlmann; K Lehmann; M Conrad; R Vosshenrich Journal: Eur J Nucl Med Mol Imaging Date: 2003-04-04 Impact factor: 9.236
Authors: Francois Jamar; John Buscombe; Arturo Chiti; Paul E Christian; Dominique Delbeke; Kevin J Donohoe; Ora Israel; Josep Martin-Comin; Alberto Signore Journal: J Nucl Med Date: 2013-01-28 Impact factor: 10.057
Authors: Steven M. Larson; Yusuf Erdi; Timothy Akhurst; Madhu Mazumdar; Homer A. Macapinlac; Ronald D. Finn; Cecille Casilla; Melissa Fazzari; Neil Srivastava; Henry W.D. Yeung; John L. Humm; Jose Guillem; Robert Downey; Martin Karpeh; Alfred E. Cohen; Robert Ginsberg Journal: Clin Positron Imaging Date: 1999-05
Authors: Andor W J M Glaudemans; Erik F J de Vries; Filippo Galli; Rudi A J O Dierckx; Riemer H J A Slart; Alberto Signore Journal: Clin Dev Immunol Date: 2013-08-21
Authors: Peter C Grayson; Sara Alehashemi; Armin A Bagheri; Ali Cahid Civelek; Thomas R Cupps; Mariana J Kaplan; Ashkan A Malayeri; Peter A Merkel; Elaine Novakovich; David A Bluemke; Mark A Ahlman Journal: Arthritis Rheumatol Date: 2018-02-06 Impact factor: 10.995
Authors: Kaitlin A Quinn; Mark A Ahlman; Ashkan A Malayeri; Jamie Marko; Ali Cahid Civelek; Joel S Rosenblum; Armin A Bagheri; Peter A Merkel; Elaine Novakovich; Peter C Grayson Journal: Ann Rheum Dis Date: 2018-04-17 Impact factor: 19.103
Authors: Dan Pugh; Maira Karabayas; Neil Basu; Maria C Cid; Ruchika Goel; Carl S Goodyear; Peter C Grayson; Stephen P McAdoo; Justin C Mason; Catherine Owen; Cornelia M Weyand; Taryn Youngstein; Neeraj Dhaun Journal: Nat Rev Dis Primers Date: 2022-01-06 Impact factor: 65.038
Authors: Lisa Duff; Andrew F Scarsbrook; Sarah L Mackie; Russell Frood; Marc Bailey; Ann W Morgan; Charalampos Tsoumpas Journal: J Nucl Cardiol Date: 2022-03-23 Impact factor: 5.952
Authors: Mark A Ahlman; Davis M Vigneault; Veit Sandfort; Roberto Maass-Moreno; Jenny Dave; Ahmed Sadek; Marissa B Mallek; Mariana A F Selwaness; Peter Herscovitch; Nehal N Mehta; David A Bluemke Journal: PLoS One Date: 2017-11-13 Impact factor: 3.240