title: Positron emission tomography assessment of large vessel inflammation in patients with newly diagnosed, biopsy-proven giant cell arteritis: a prospective, case-control study.
abstract: BACKGROUND
  Positron emission tomography (PET) scan is emerging as a promising imaging technique to detect large-vessel inflammation in giant cell arteritis (GCA). However, the lack of a standardised definition of arteritis based on (18)fluorodeoxyglucose (FDG) uptake is an important limitation to the use of PET scan for diagnostic purposes.
  
  
  OBJECTIVE
  To prospectively assess the intensity and distribution of FDG uptake at different vascular territories in patients with newly diagnosed GCA compared with controls.
  
  
  METHODS
  32 consecutive, biopsy-proven, GCA patients treated with glucocorticoids for ≤3 days were included. The control group consisted of 20 individuals, who underwent PET/CT for cancer staging. Maximal standardised uptake value (SUVm) was calculated at four aortic segments, supraaortic branches and iliac-femoral territory. Sensitivity and specificity was calculated by receiver-operator characteristic curves (ROC) analysis.
  
  
  RESULTS
  Mean SUVm was significantly higher in patients than in controls in all vessels explored and correlated with acute-phase reactants and serum IL-6. Mean of the SUVm at all the vascular territories had an area under the curve (AUC) of 0.830, and a cut-off of 1.89 yielded a sensitivity of 80% and a specificity of 79% for GCA diagnosis. There were no significant differences in AUC among the vascular beds examined.
  
  
  CONCLUSIONS
  FDG uptake by large vessels has a substantial sensitivity and specificity for GCA diagnosis.
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Sergio
authors.initials: S
authors.lastname: Prieto-González
authors.affiliation: Center for Diagnostic Imaging, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Marina
authors.initials: M
authors.lastname: Depetris
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain Department of Emergency Medicine, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Ana
authors.initials: A
authors.lastname: García-Martínez
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Georgina
authors.initials: G
authors.lastname: Espígol-Frigolé
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Itziar
authors.initials: I
authors.lastname: Tavera-Bahillo
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Marc
authors.initials: M
authors.lastname: Corbera-Bellata
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Ester
authors.initials: E
authors.lastname: Planas-Rigol
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Marco A
authors.initials: MA
authors.lastname: Alba
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: José
authors.initials: J
authors.lastname: Hernández-Rodríguez
authors.affiliation: Department of Internal Medicine, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Josep M
authors.initials: JM
authors.lastname: Grau
authors.affiliation: Center for Diagnostic Imaging, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Franciso
authors.initials: F
authors.lastname: Lomeña
authors.affiliation: Vasculitis Research Unit, Department of Systemic Autoimmune Diseases, Hospital Clínic, University of Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Cid
mesh_terms: D000209:Acute-Phase Proteins / Q000276:immunology; D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000000981:diagnostic imaging; D019540:Area Under Curve; D001158:Arteries / Q000000981:diagnostic imaging* / Q000473:pathology; D001366:Axillary Artery / Q000000981:diagnostic imaging; D001706:Biopsy; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging* / Q000276:immunology / Q000473:pathology; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging; D015850:Interleukin-6 / Q000276:immunology; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012680:Sensitivity and Specificity; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D013699:Temporal Arteries / Q000473:pathology; D014057:Tomography, X-Ray Computed
chemical_list: D000209:Acute-Phase Proteins; D015850:Interleukin-6; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: acute-phase reactants; diagnosis; giant-cell arteritis; imaging; inflammation; interleukin-6; large-vessel vasculitis; positron-emission tomography