Cranial and large vessel activity on positron emission tomography scan at diagnosis and 6 months in giant cell arteritis.
Adrenal Cortex Hormones
/ therapeutic use
Aged
Aged, 80 and over
Female
Fluorodeoxyglucose F18
/ administration & dosage
Giant Cell Arteritis
/ diagnostic imaging
Humans
Male
New South Wales
Positron Emission Tomography Computed Tomography
Predictive Value of Tests
Prospective Studies
Radiopharmaceuticals
/ administration & dosage
Recurrence
Time Factors
Treatment Outcome
giant cell arteritis
positron emission tomography
prognosis
systemic vasculitis
Journal
International journal of rheumatic diseases
ISSN: 1756-185X
Titre abrégé: Int J Rheum Dis
Pays: England
ID NLM: 101474930
Informations de publication
Date de publication:
Apr 2020
Apr 2020
Historique:
received:
15
12
2019
revised:
14
01
2020
accepted:
21
01
2020
pubmed:
27
2
2020
medline:
29
1
2021
entrez:
27
2
2020
Statut:
ppublish
Résumé
Positron emission tomography/computed tomography (PET/CT) can detect cranial and large vessel inflammation in giant cell arteritis (GCA). We aimed to determine the change and significance of vascular activity at diagnosis and 6 months. Newly diagnosed GCA patients underwent time-of-flight fluorine-18-fluoro-2-deoxyglucose PET/CT from vertex to diaphragm within 72 hours of commencing corticosteroids and were followed for 12 months. A 6 months scan was performed in patients with inflammatory features on biopsy or CT aortitis. Vascular uptake was visually graded by 2 blinded readers across 18 artery segments from 0 (no increased uptake) to 3 (very marked uptake). Scores were summed to give a total vascular score (TVS). We enrolled 21 GCA patients and 15 underwent the serial scan. Twelve (57%) patients experienced a relapse and 5 of these had ischemic features of vision disturbance, jaw or limb claudication. The median TVS fell from 14 (interquartile range [IQR] 4-24) at baseline to 5 (IQR 0-10) at 6 months (P < .01) with reduction in both cranial and large artery scores. While the overall relapse rate was similar between patients with a high (≥10) and low baseline TVS, patients with high scores were numerically more likely to experience an ischemic relapse (33% vs 11%, P = .34). Five out of 15 patients had persistent uptake in at least 1 vessel on the serial PET/CT but none experienced a subsequent relapse. Vascular activity decreased in cranial and large arteries between diagnosis and 6 months. Persistent activity did not predict subsequent relapse.
Identifiants
pubmed: 32100451
doi: 10.1111/1756-185X.13805
doi:
Substances chimiques
Adrenal Cortex Hormones
0
Radiopharmaceuticals
0
Fluorodeoxyglucose F18
0Z5B2CJX4D
Types de publication
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
582-588Subventions
Organisme : Arthritis Australia
Informations de copyright
© 2020 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.
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