title: Rheumatoid arthritis: Nuclear Medicine state-of-the-art imaging.
abstract: Rheumatoid arthritis (RA) is an autoimmune disease, which is associated with systemic and chronic inflammation of the joints, resulting in synovitis and pannus formation. For several decades, the assessment of RA has been limited to conventional radiography, assisting in the diagnosis and monitoring of disease. Nevertheless, conventional radiography has poor sensitivity in the detection of the inflammatory process that happens in the initial stages of RA. In the past years, new drugs that significantly decrease the progression of RA have allowed a more efficient treatment. Nuclear Medicine provides functional assessment of physiological processes and therefore has significant potential for timely diagnosis and adequate follow-up of RA. Several single photon emission computed tomography (SPECT) and positron emission tomography (PET) radiopharmaceuticals have been developed and applied in this field. The use of hybrid imaging, which permits computed tomography (CT) and nuclear medicine data to be acquired and fused, has increased even more the diagnostic accuracy of Nuclear Medicine by providing anatomical localization in SPECT/CT and PET/CT studies. More recently, fusion of PET with magnetic resonance imaging (PET/MRI) was introduced in some centers and demonstrated great potential. In this article, we will review studies that have been published using Nuclear Medicine for RA and examine key topics in the area.
authors.affiliation: Paulo Henrique Rosado-de-Castro, Sergio Augusto Lopes de Souza, Lea Mirian Barbosa da Fonseca, Bianca Gutfilen, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Paulo Henrique
authors.initials: PH
authors.lastname: Rosado-de-Castro
authors.affiliation: Paulo Henrique Rosado-de-Castro, Sergio Augusto Lopes de Souza, Lea Mirian Barbosa da Fonseca, Bianca Gutfilen, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Sergio Augusto
authors.initials: SA
authors.lastname: Lopes de Souza
authors.affiliation: Paulo Henrique Rosado-de-Castro, Sergio Augusto Lopes de Souza, Lea Mirian Barbosa da Fonseca, Bianca Gutfilen, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Dângelo
authors.initials: D
authors.lastname: Alexandre
authors.affiliation: Paulo Henrique Rosado-de-Castro, Sergio Augusto Lopes de Souza, Lea Mirian Barbosa da Fonseca, Bianca Gutfilen, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Lea Mirian
authors.initials: LM
authors.lastname: Barbosa da Fonseca
authors.affiliation: Paulo Henrique Rosado-de-Castro, Sergio Augusto Lopes de Souza, Lea Mirian Barbosa da Fonseca, Bianca Gutfilen, Departamento de Radiologia, Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
authors.forename: Bianca
authors.initials: B
authors.lastname: Gutfilen
keywords: Nuclear medicine; Positron emission tomography; Rheumatoid arthritis; Scintigraphy; Single photon emission computed tomography