title: Present role of positron emission tomography in the diagnosis and monitoring of peripheral inflammatory arthritis: a systematic review.
abstract: OBJECTIVE
  To determine the current status of positron emission tomography (PET) as a tool for diagnosis and monitoring of peripheral inflammatory arthritis (IA).
  
  
  METHODS
  For conducting this systematic review, the PubMed (Medline), Embase, and Cochrane Library databases were searched until December 31, 2012. Studies of PET for diagnosis and/or therapy monitoring of peripheral IA were included. Data were summarized qualitatively using best evidence synthesis.
  
  
  RESULTS
  Eighteen articles met our inclusion criteria. The majority of studies were feasibility studies with varying methods applied. All studies demonstrated that PET visualized IA with high sensitivity, corresponding to clinical assessments. PET outcome of clinically active IA also matched that of ultrasound and magnetic resonance imaging. PET differentiates from other modalities by (quantitative) imaging of molecular sites in the synovium. The first studies reporting on the potential clinical applications of PET to image subclinical synovitis in preclinical RA and during therapy have been published. The results are promising, but the number and study populations of these studies are still limited.
  
  
  CONCLUSIONS
  Thus far, a limited number of PET studies addressing IA imaging have been published. The PET modality seems to offer highly sensitive and potentially specific imaging of IA at the (quantitative) molecular level. Clinical application studies for early diagnostics and therapy monitoring are arising, but these topics should be further explored in future studies with larger cohorts. For integration in clinical practice, aspects such as radiation burden and cost-effectiveness should also be taken into account.
authors.affiliation: VU University Medical Center, Amsterdam, The Netherlands.
authors.forename: S T G
authors.initials: ST
authors.lastname: Bruijnen
authors.forename: Y Y J
authors.initials: YY
authors.lastname: Gent
authors.forename: A E
authors.initials: AE
authors.lastname: Voskuyl
authors.forename: O S
authors.initials: OS
authors.lastname: Hoekstra
authors.forename: C J
authors.initials: CJ
authors.lastname: van der Laken
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001168:Arthritis / Q000175:diagnosis* / Q000000981:diagnostic imaging* / Q000188:drug therapy; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D005260:Female; D006801:Humans; D007223:Infant; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography / Q000379:methods*; D012680:Sensitivity and Specificity; D013583:Synovial Membrane / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult
chemical_list: D018501:Antirheumatic Agents