title: Clinical value of ¹⁸F-fluoro-dexoxyglucose positron emission tomography/computed tomography in patients with adult-onset Still's disease: a seven-case series and review of the literature.
abstract: OBJECTIVE
  While there are a few reports describing 18F-fluoro-dexoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) findings in patients with adult-onset Still's disease (AOSD), no summary report has yet been published. In this study, we evaluated the usefulness of FDG-PET/CT for diagnosis and activity evaluation in patients with AOSD by summarizing the findings of our patients and those reported in the literature.
  
  
  METHODS
  Seven consecutive AOSD patients who had undergone PET/CT at our department between 2007 and 2012 were included. We evaluated FDG uptake for characteristic findings in patients with AOSD. In addition, we reviewed the literature on seven previously reported AOSD patients who had undergone PET/CT.
  
  
  RESULTS
  FDG accumulation was positive mainly in the bone marrow (100%), spleen (90.9%), lymph nodes (80.0%) and joints (75.0%). In addition, FDG uptake was positive in the pericardium, pleura, salivary glands, eyelids, muscle and major blood vessels. Six patients underwent follow-up FDG PET/CT for evaluation of treatment efficacy. Follow-up PET/CT showed diminished FDG accumulation in the bone marrow, spleen and lymph nodes, with maximum standardized uptake value (SUVmax) being substantially reduced from 4.03 ± 0.95 to 2.20 ± 0.75 (p = 0.04), 4.04 ± 1.10 to 2.55 ± 1.13 (p = 0.04) and 5.63 ± 4.99 to 2.10 ± 1.91 (p = 0.11), respectively. No significant correlation was found between SUVmax in each lesion and the laboratory data, except for a significant correlation between lactate dehydrogenase (LDH) and spleen SUV.
  
  
  CONCLUSIONS
  FDG-PET/CT is useful for long-term assessments of AOSD activity in individual patients. However, PET/CT findings alone are not sufficient to make a differential diagnosis of AOSD versus malignant lymphoma.
authors.affiliation: Division of Rheumatic Diseases, National Center for Global Health and Medicine , Tokyo , Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamashita
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kubota
authors.forename: Yuko
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Ryogo
authors.initials: R
authors.lastname: Minamimoto
authors.forename: Miyako
authors.initials: M
authors.lastname: Morooka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kaneko
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Kano
authors.forename: Akio
authors.initials: A
authors.lastname: Mimori
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008223:Lymphoma / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography / Q000379:methods*; D019275:Radiopharmaceuticals; D016706:Still's Disease, Adult-Onset / Q000000981:diagnostic imaging*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-fluoro-dexoxyglucose positron emission tomography/computed tomography; Adult-onset Still's disease