Quantification of inflammation in the wrist with gadolinium-enhanced MR imaging and PET with 2-[F-18]-fluoro-2-deoxy-D-glucose.
OBJECTIVE
To quantify the activity of joint inflammation with magnetic resonance (MR) imaging and positron emission tomography (PET).


METHODS
Gadolinium-enhanced MR imaging and 2-[fluorine-18]fluoro-2-deoxy-D-glucose (FDG) PET of the wrist were performed prospectively in 12 patients receiving antiinflammatory therapy. Patients were studied three times: off medications for 2 weeks, after 2 weeks of treatment with prednisone or nonsteroid antiinflammatory drugs, and after 12 weeks of treatment with methotrexate. Volume of enhancing pannus (VEP) was determined from fat-suppressed MR images (12 patients). FDG uptake was calculated from PET images (11 patients).


RESULTS
VEP and FDG uptake were closely correlated (r > .86, P < .0001), as were changes in VEP and standardized uptake volume (r > .91, P < .0002). VEP and FDG uptake were strongly associated with clinical findings in wrists (P < .002) but not with treatment outcomes (P > .05).


CONCLUSIONS
Contrast material-enhanced MR imaging and PET allow quantification of volumetric and metabolic changes in joint inflammation and comparison of efficacies of antiinflammatory drugs.
Palmer
W E
WE
Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
Rosenthal
D I
DI
Schoenberg
O I
OI
Fischman
A J
AJ
Simon
L S
LS
Rubin
R H
RH
Polisson
R P
RP
D000082:Acetaminophen / Q000627:therapeutic use; D000328:Adult; D000368:Aged; D015535:Arthritis, Psoriatic / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D001172:Arthritis, Rheumatoid / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D003287:Contrast Media; D003847:Deoxyglucose / Q000031:analogs & derivatives*; D011431:Dextropropoxyphene / Q000627:therapeutic use; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D005682:Gadolinium; D006801:Humans; D007089:Image Enhancement; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D011241:Prednisone / Q000627:therapeutic use; D011446:Prospective Studies; D014055:Tomography, Emission-Computed; D016896:Treatment Outcome; D014955:Wrist Joint / Q000000981:diagnostic imaging* / Q000473:pathology*
D003287:Contrast Media; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D000082:Acetaminophen; D003847:Deoxyglucose; D005682:Gadolinium; D011431:Dextropropoxyphene; D011241:Prednisone