[18FDG-PET and large vessel vasculitis: preliminary data on 25 patients].
OBJECTIVE
To evaluate the predictive value of clinical and biochemical features when compared to 18FDG-PET in the diagnostic work-up of large vessel vasculitis (LVV).


METHODS
Twenty-five patients underwent 18FDG-PET for the clinical suspect of LVV. All of them presented history of systemic symptoms lasting >or=6 months and laboratoristic evidence of persistently high markers of inflammation. The patients were stratified according with: i) clinical manifestations, defined as presence of one or more ACR criteria for the classification of LVV; ii) laboratory investigations: Erythrocyte Sedimentation Rate (ESR) higher or lower than 50 mm/h, C-Reactive Protein (CRP) higher or lower than 2 mg/dl; iii) prednisone dose in the 4 weeks preceding PET examination.


RESULTS
The total number of positive PET was higher in the group without clinical ACR criteria and in the group with inflammation markers under the established cut-off. The number of scans consistent with LVV was higher in the groups presenting one or more clinical criteria for LVV but in those with very high ESR and CRP. In all the cases differences between groups were not statistically significative. A clear cut negative correlation between steroid dose and number of scans suggestive for LVV has been observed.


CONCLUSIONS
Diagnosis of LVV remains challenging, especially in patients presenting with a constellation of non-specific symptoms and laboratory findings. In this study, both clinical and biochemical features show low correlation with a vasculitic pattern of FDG uptake. In our experience 18FDG-PET represents an useful diagnostic tool in early stages of LVV and a powerful instrument to follow the treatment responses.
Bruschi
M
M
Cattedra e Unità Operativa Complessa di Reumatologia, Dipartimento di Medicina Clinica e Sperimentale, Università degli Studi di Ferrara, Azienda Ospedaliera-Universitaria Ospedale S. Anna, Ferrara. bruschi.marco@gmail.com
De Leonardis
F
F
Govoni
M
M
Roncali
M
M
Prandini
N
N
La Corte
R
R
Feggi
L
L
Trotta
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D001799:Blood Sedimentation; D002097:C-Reactive Protein / Q000032:analysis; D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011241:Prednisone / Q000627:therapeutic use; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D013625:Takayasu Arteritis / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000188:drug therapy; D014657:Vasculitis / Q000097:blood / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein; D011241:Prednisone
18FDG-PET e vasculiti dei grandi vasi: studio preliminare su 25 pazienti.