18F-FDG-PET/CT Scan for Detection of Large Vessel Involvement in Giant Cell Arteritis: Arteser Spanish Registry
Year: 2024
Type: article
Study design: Observational Study
Abstract: ABSTRACT Background: Positron emission tomography/computed tomography (PET/CT) using 18-fluorodeoxyglucose (18F-FDG) is crucial for large vessel vasculitis (LVV) assessment in giant cell arteritis (GCA)Objectives: We aimed to determine the utility of 18F-FDG-PET/CT scan in detecting LVV in GCA. Method: ARTESER registry, is a large multicenter, retrospective, observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed GCA across country from June 1st, 2013 to March 29th, 2019. Patients were entered if diagnosed with incidental GCA, and specific criteria including: ACR 1990 criteria, positive imaging results, or expert clinical opinion. Differences between patients with positive and negative 18F-FDG-PET/CT were analyzed using a bivariate model. A regression model assessed associations in positive scans, and ROC analysis evaluated the sensitivity and specificity of the 18F-FDG-PET/CT scan for newly diagnosed GCA. Results: Out of 1675 GCA patients in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as days went by. Depending on the cumulative dosage of glucocorticoids, 18F-FDG-PET/CT scan showed an AUC of 0.74.Conclusions: Younger patients showed a higher probability of presenting LVV as detected by 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of glucocorticoids influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation. Key indexing terms: 18F-FDG-PET/CT scan, large vessel vasculitis, aortitis, giant cell arteritis, imaging, nuclear medicine. KEY POINTS• What is already known on this topic:- Novel imaging methods, notably 18F-FDG-PET/CT, greatly improve GCA extracranial phenotype diagnosis, especially in detecting aorta and major branches involvement.• What this study adds:- Younger GCA patients show higher LVV risk.- Integrating early 18F-FDG-PET/CT scans enhances inflammation detection, while considering the impact of glucocorticoid dosage on scan outcomes for comprehensive assessmentHow this study might affect research, practice or policy: - Future research is needed to develop imaging protocols in different clinical scenarios.
Source: Journal of Clinical Medicine
DOI: 10.3390/jcm13206215
Authors: Paula Estrada, Marta Domínguez-Álvaro, Rafael B. Melero-González, Eugenio de Miguel, Maite Silva-Díaz, Jesús A. Valero, Ismael González, Julio Sánchez-Martín, Javier Narváez, Eva Galíndez, Javier Mendizábal, Carlota L. Iñiguez-Ubiaga, Luis Rodríguez-Rodríguez, Javier Loricera, Alejandro Muñoz, Patricia Moya-Alvarado, Patricia Moran-Álvarez, Vanessa A. Navarro-Ángeles, Carlos Galisteo, Santos Castañeda, Ricardo Blanco, on behalf of ARTESER Project Collaborative Group
Institutions: Hospital de Sant Joan Despí Moisès Broggi, Universitat de Barcelona, Sociedad Española de Reumatología, University Hospital Complex Of Vigo, Hospital Universitario La Paz, Complexo Hospitalario Universitario A Coruña, Hospital Universitario de León, Hospital Universitario 12 De Octubre, Bellvitge University Hospital, Hospital de Basurto, Complejo Hospitalario de Navarra, Hospital Universitario Lucus Augusti, Hospital Clínico San Carlos, Marqués de Valdecilla University Hospital, Instituto de Investigación Marqués de Valdecilla, Hospital Universitario Virgen del Rocío, Hospital de Sant Pau, Hospital Universitario Ramón y Cajal, Corporació Sanitària Parc Taulí, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria del Hospital Universitario de La Princesa
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,955
OpenAlex ID: W4403517457