title: Integration of 2-deoxy-2-[18F] fluoro-D-glucose PET/CT into clinical management of patients with Wegener's granulomatosis.
abstract: OBJECTIVE
  Wegener's granulomatosis (WG) is a rare disorder characterized by granulomatous necrotizing vasculitis which mainly affects small- and medium-sized vessels. While the classical triad of involvement is upper and lower respiratory system and glomerulonephritis, WG may involve any organ or system in the body. The aim of our study was to investigate the role of positron emission tomography/computerized tomography (PET/CT) both in the initial evaluation and follow-up of patients with WG.
  
  
  METHODS
  We retrospectively evaluated PET/CT data from 13 patients (6 males; 7 females) with a mean age of 45 ± 12.4 years (range 28-63) who underwent either initial evaluation (n = 12) or response evaluation (n = 2) by conventional imaging methods and FDG with PET/CT. PET/CT images were both visually and quantitatively evaluated. The demographic data, clinical and laboratory findings of each patient were also recorded from the hospital files.
  
  
  RESULTS
  Lung (n = 13), parapharyngeal space (n = 8), nose (n = 8), and ear (n = 3) were the most common disease sites detected on PET/CT. The entire initial evaluation patients had either solitary or multiple pulmonary nodular/mass lesions with marked increased FDG uptake (mean SUVmax 12 ± 4, range 3.53-19.51) on PET/CT. There was no significant pathological FDG uptake in patients consistent with complete treatment response after appropriate immunosuppressive therapy. PET/CT clearly demonstrated unexpected disease sites besides the respiratory system, with WG involvement except kidneys. Possibly due to physiological urinary excretion of FDG, urine analysis, BUN and creatinine levels were accepted still the best way for diagnosis of renal involvement.
  
  
  CONCLUSIONS
  FDG with PET/CT is a valuable tool in the management of patients with WG for a more accurate clinical evaluation regarding disease extension and treatment response.
authors.affiliation: Department of Nuclear Medicine, Ataturk Chest Diseases and Thoracic Surgery Training and Research Hospital, Sanatoryum Cad., 06280, Kecioren, Ankara, Turkey, ozmenozlem@yahoo.com.
authors.forename: Ozlem
authors.initials: O
authors.lastname: Ozmen
authors.forename: Ebru
authors.initials: E
authors.lastname: Tatci
authors.forename: Atila
authors.initials: A
authors.lastname: Gokcek
authors.forename: Deniz
authors.initials: D
authors.lastname: Koksal
authors.forename: Yeliz
authors.initials: Y
authors.lastname: Dadali
authors.forename: Esra
authors.initials: E
authors.lastname: Ozaydin
authors.forename: Nuri
authors.initials: N
authors.lastname: Arslan
mesh_terms: D000328:Adult; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D014890:Granulomatosis with Polyangiitis / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
chemical_list: D019788:Fluorodeoxyglucose F18