Comparison of F18-FDG PET/CT findings with current clinical disease status in patients with Takayasu's arteritis

• Published in: Clinical and experimental rheumatology Vol. 31; no. 1 Suppl 75; pp. S15 - S21
• Main Authors: Karapolat, I, Kalfa, M, Keser, G, Yalçin, M, Inal, V, Kumanlioğlu, K, Pirildar, T, Aksu, K
• Format: Journal Article
• Language: English
• Published: Italy 01.01.2013
• Subjects: Adolescent; Adult; Chi-Square Distribution; Cross-Sectional Studies; Female; Fluorodeoxyglucose F18; Humans; Immunosuppressive Agents - therapeutic use; Male; Middle Aged; Multimodal Imaging; Positron-Emission Tomography; Predictive Value of Tests; Radiopharmaceuticals; Recurrence; Remission Induction; Sensitivity and Specificity; Severity of Illness Index; Takayasu Arteritis - diagnostic imaging; Takayasu Arteritis - drug therapy; Time Factors; Tomography, X-Ray Computed; Treatment Outcome; Young Adult
• ISSN: 0392-856X

18F-fluorodeoxyglucose-positron emission tomography/computed tomography (F-18 FDG PET/CT) scanning has been proposed as a new tool to assess disease activity in Takayasu Arteritis (TA). We investigated whether F-18 FDG PET/CT findings were consistent with current clinical disease status in patients with TA. In this cross-sectional study, 22 patients with TA were enrolled. Clinical disease activity was assessed by the combination of National Institutes of Health (NIH) criteria, Disease Extent Index-Takayasu (DEI-Tak) score, physician global assessment and F-18 FDG PET/CT scans. At the time F-18 FDG PET/CT scans were taken, the majority of the patients (17/22) were using immunosuppressive (IS) drugs, and only four patients had clinically active disease. F-18 FDG PET/CT scans confirmed the presence of active vasculitic lesions in those four patients. In 16 out of 18 patients who were accepted to be in clinical remission, F-18 FDG PET/CT scans were also normal. There were only two patients with discordant results, i.e. active F-18 FDG PET/CT findings despite the lack of clinical activity. Interestingly, clinical exacerbation occurred four weeks later in one of them. Overall sensitivity and specificity of F-18 FDG PET/CT findings for clinical activity were 100% and 88.9%, respectively. We found that F-18 FDG PET/CT findings were generally consistent with clinical disease status in TA. Although use of IS drugs certainly impairs diagnostic accuracy of F-18 FDG PET/CT in TA, this imaging method may still have a potential for confirming remission or detecting disease activity in patients with TA receiving treatment.