Prognostic factors in giant cell arteritis associated aortitis with PET/CT and CT angiography at diagnosis.

Humans Female Middle Aged Aged Positron Emission Tomography Computed Tomography Aortitis / complications Computed Tomography Angiography / adverse effects Giant Cell Arteritis / complications Prognosis Fluorodeoxyglucose F18 Radiopharmaceuticals

Aortitis CT scan FDG-PET/CT Giant cell arteritis Large vessel vasculitis Prognosis

Journal

Seminars in arthritis and rheumatism

ISSN: 1532-866X

Titre abrégé: Semin Arthritis Rheum

Pays: United States

ID NLM: 1306053

Informations de publication

Date de publication:
04 2023

Historique:

received: 12 12 2022

revised: 26 01 2023

accepted: 06 02 2023

pubmed: 22 2 2023

medline: 4 3 2023

entrez: 21 2 2023

Statut: ppublish

Résumé

Prognosis data on giant-cell arteritis (GCA)-associated aortitis are scarce and heterogeneous. The aim of this study was to compare the relapses of patients with GCA-associated aortitis according to the presence of aortitis on CT-angiography (CTA) and/or on FDG-PET/CT. This multicenter study included GCA patients with aortitis at diagnosis; each case underwent both CTA and FDG-PET/CT at diagnosis. A centralized review of image was performed and identified patients with both CTA and FDG-PET/CT positive for aortitis (Ao-CTA+/PET+); patients with positive FDG-PET/CT but negative CTA for aortitis (Ao-CTA-/PET+), and patients solely positive on CTA. Eighty-two patients were included with 62 (77%) of female sex. Mean age was 67±8 years; 64 patients (78%) were in the Ao-CTA+/PET+ group; 17 (22%) in the Ao-CTA-/PET+ group and 1 had aortitis only on CTA. Overall, 51 (62%) patients had at least one relapse during follow-up: 45/64 (70%) in the Ao-CTA+/PET+ group and 5/17 (29%) in the Ao-CTA-/PET+ group (log rank, p = 0.019). In multivariate analysis, aortitis on CTA (Hazard Ratio 2.90, p = 0.03) was associated with an increased risk of relapse. Positivity of both CTA and FDG-PET/CT for GCA-related aortitis was associated with an increased risk of relapse. Aortic wall thickening on CTA was a risk factor of relapse compared with isolated aortic wall FDG uptake.

Sections du résumé

BACKGROUND

METHODS

This multicenter study included GCA patients with aortitis at diagnosis; each case underwent both CTA and FDG-PET/CT at diagnosis. A centralized review of image was performed and identified patients with both CTA and FDG-PET/CT positive for aortitis (Ao-CTA+/PET+); patients with positive FDG-PET/CT but negative CTA for aortitis (Ao-CTA-/PET+), and patients solely positive on CTA.

RESULTS

Eighty-two patients were included with 62 (77%) of female sex. Mean age was 67±8 years; 64 patients (78%) were in the Ao-CTA+/PET+ group; 17 (22%) in the Ao-CTA-/PET+ group and 1 had aortitis only on CTA. Overall, 51 (62%) patients had at least one relapse during follow-up: 45/64 (70%) in the Ao-CTA+/PET+ group and 5/17 (29%) in the Ao-CTA-/PET+ group (log rank, p = 0.019). In multivariate analysis, aortitis on CTA (Hazard Ratio 2.90, p = 0.03) was associated with an increased risk of relapse.

CONCLUSION

Positivity of both CTA and FDG-PET/CT for GCA-related aortitis was associated with an increased risk of relapse. Aortic wall thickening on CTA was a risk factor of relapse compared with isolated aortic wall FDG uptake.

Identifiants

DOI: 10.1016/j.semarthrit.2023.152172 PMID: 36801668

pubmed: 36801668

pii: S0049-0172(23)00012-4

doi: 10.1016/j.semarthrit.2023.152172

pii:

doi:

Substances chimiques

Fluorodeoxyglucose F18 0Z5B2CJX4D

Radiopharmaceuticals 0

Types de publication

Multicenter Study Journal Article

Langues

eng

Sous-ensembles de citation

Pagination

152172

Informations de copyright

Déclaration de conflit d'intérêts

Declaration of Competing Interest Authors have no conflict of interest for this study.