title: Systemic and vascular inflammation in patients with moderate to severe psoriasis as measured by [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT): a pilot study.
abstract: OBJECTIVE
  To evaluate the feasibility of using [18F]-fluorodeoxyglucose positron emission tomography-computed tomography (FDG-PET/CT) to detect and quantify systemic inflammation in patients with psoriasis.
  
  
  METHODS
  Case series with a nested case-control study.
  
  
  METHODS
  Referral dermatology and preventive cardiology practices.
  
  
  METHODS
  Six patients with psoriasis affecting more than 10% of their body surface area and 4 controls age and sex matched to 4 of the patients with psoriasis for a nested case-control study.
  
  
  METHODS
  The FDG uptake in the liver, musculoskeletal structures, and aorta measured by mean standardized uptake value, a measure of FDG tracer uptake by macrophages and other inflammatory cells.
  
  
  RESULTS
  FDG-PET/CT identified numerous foci of inflammation in 6 patients with psoriasis within the skin, liver, joints, tendons, and aorta. Inflammation in the joints was observed in a patient with psoriatic arthritis as well as in 1 patient with no history of joint disease or joint symptoms. In a nested case-control study, FDG-PET/CT imaging demonstrated increased vascular inflammation in multiple segments of the aorta compared with controls. These findings persisted after adjustment for traditional cardiovascular risk factors in multivariate analysis (mean β = 0.33; P < .001). Patients with psoriasis further demonstrated increased hepatic inflammation after adjusting for cardiovascular risk factors (β = 0.18; P < .001), but the association was no longer significant when adjusted for alcohol intake (β = -0.25; P = .07).
  
  
  CONCLUSIONS
  FDG-PET/CT is a sensitive tool for identifying inflammation and can be used to identify clinically observed inflammation in the skin and subclinical inflammation in the blood vessels, joints, and liver of patients with psoriasis.
authors.affiliation: Cardiovascular Institute, University of Pennsylvania School of Medicine, 6 Penn Tower, Philadelphia, PA 19104, USA. nehal.mehta@uphs.upenn.edu
authors.forename: Nehal N
authors.initials: NN
authors.lastname: Mehta
authors.forename: YiDing
authors.initials: Y
authors.lastname: Yu
authors.forename: Babak
authors.initials: B
authors.lastname: Saboury
authors.forename: Negar
authors.initials: N
authors.lastname: Foroughi
authors.forename: Parasuram
authors.initials: P
authors.lastname: Krishnamoorthy
authors.forename: Anna
authors.initials: A
authors.lastname: Raper
authors.forename: Amanda
authors.initials: A
authors.lastname: Baer
authors.forename: Jules
authors.initials: J
authors.lastname: Antigua
authors.forename: Abby S
authors.initials: AS
authors.lastname: Van Voorhees
authors.forename: Drew A
authors.initials: DA
authors.lastname: Torigian
authors.forename: Abass
authors.initials: A
authors.lastname: Alavi
authors.forename: Joel M
authors.initials: JM
authors.lastname: Gelfand
mesh_terms: D000328:Adult; D001011:Aorta / Q000000981:diagnostic imaging; D001027:Aortography; D001175:Arthrography; D016022:Case-Control Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D007249:Inflammation; D007596:Joints / Q000000981:diagnostic imaging; D008099:Liver / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011565:Psoriasis / Q000000981:diagnostic imaging*; D019275:Radiopharmaceuticals; D012867:Skin / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D051598:Whole Body Imaging
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18