[Horton's disease and extra-temporal vessel locations: role of 18FDG PET scan. Report of 3 cases and review of the literature].
OBJECTIVE
We report three cases of Horton's disease, in which F18-Fluorine-2-Deoxy-D-Glucose (18FDG) positron emission tomography (PET) demonstrated a clinically unsuspected extra-cranial vessels hypermetabolism.


METHODS
Fully corrected whole-body PET was performed in three patients (two women, one man) for exploring a marked inflammatory syndrome. Scanning was acquired 60 min after i.v. injection of 222 MBq of 18FDG in average.


RESULTS
In two patients with histologically proven Horton's disease, PET alone showed increased glucose metabolism involving the carotid and sub-clavian arteries as well as the ascending aorta, aortic arch, thoracic and abdominal aorta, and the iliac and femoral arteries. In the third patient, by detecting cervical, thoracic and abdominal vessel hypermetabolism, PET non-invasively contributed to the diagnosis of giant cell arteritis. All patients had complete clinical and biological response to corticoids. PET controls performed 3- to 6-months post-treatment, confirmed the disappearance of the metabolic stigma.


CONCLUSIONS
18FDG PET may show an increased glucose metabolism in asymptomatic extracranial vessels locations of Horton's arterities. If these observations are confirmed on controlled trials, PET could be particularly useful for non-invasive diagnosing, staging and monitoring atypical clinical forms of Horton's disease. The metabolic imaging could also contribute to a better understanding of the pathogenesis of GCA.
Belhocine
T
T
Service de médecine nucléaire, CHU de Liège, Sart Tilman, Bât.35, 4000 Liège, Belgique. tarik.bel@swing.be
Kaye
O
O
Delanaye
P
P
Corman
V
V
Baghaie
M
M
Deprez
M
M
Daenen
F
F
De Barsy
C
C
Beckers
C
C
Gomez
P
P
Hustinx
R
R
Foidart-Willems
J
J
Demonty
J
J
Malaise
M
M
Rigo
P
P
D000368:Aged; D001011:Aorta / Q000473:pathology*; D002339:Carotid Arteries / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005947:Glucose / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D019275:Radiopharmaceuticals; D013348:Subclavian Artery / Q000473:pathology*; D014055:Tomography, Emission-Computed
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose