Fludeoxyglucose positron emission tomography in the diagnosis of giant cell arteritis.
We describe a case in which fludeoxyglucose F 18 positron emission tomography (PET) led directly to the diagnosis of giant cell arteritis in an elderly woman with a fever of unknown origin. The patient presented with a 3-month history of fatigue, fever, headache, visual disturbance, jaw claudication, and anemia. A computed tomographic scan showed an anterior mediastinal mass that was suspected of being malignant. A fludeoxyglucose F 18 PET scan performed for preoperative evaluation identified striking uptake of fludeoxyglucose F 18 in the walls of the entire aorta, left main coronary artery, and subclavian, carotid, and common iliac arteries bilaterally, suggestive of an arteritis, a diagnosis subsequently confirmed by the findings of an arterial biopsy. Her erythrocyte sedimentation rate was 129 mm/h. There was normalizaton of the PET scan 2 weeks following treatment with prednisolone. This case suggests that fludeoxyglucose F 18 PET contributes to the noninvasive diagnosis of giant cell arteritis, as well as to the evaluation of the extent of disease, response to therapy, and disease recurrence.
Turlakow
A
A
Nuclear Medicine Service, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021, USA. aturlakow@ozemail.com.au
Yeung
H W
HW
Pui
J
J
Macapinlac
H
H
Liebovitz
E
E
Rusch
V
V
Goy
A
A
Larson
S M
SM
D000368:Aged; D000747:Anemia, Hypochromic / Q000209:etiology; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001706:Biopsy; D001799:Blood Sedimentation; D005221:Fatigue / Q000209:etiology; D005260:Female; D005335:Fever of Unknown Origin / Q000209:etiology; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000097:blood / Q000150:complications / Q000000981:diagnostic imaging* / Q000188:drug therapy; D006261:Headache / Q000209:etiology; D006801:Humans; D011239:Prednisolone / Q000627:therapeutic use; D019275:Radiopharmaceuticals; D014055:Tomography, Emission-Computed / Q000379:methods*; D014057:Tomography, X-Ray Computed; D015431:Weight Loss
D000893:Anti-Inflammatory Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D011239:Prednisolone