title: Giant cell arteritis: a systematic review of the qualitative and semiquantitative methods to assess vasculitis with 18F-fluorodeoxyglucose positron emission tomography.
abstract: Giant cell arteritis (GCA) is the most common vasculitis affecting medium and large vessels. It shows a close clinical association with polymyalgia rheumatica (PMR), a musculoskeletal inflammatory disorder, which is clinically characterized by girdles pain and stiffness. 18F-Fluorodeoxyglucose (18F-FDG) positron emission tomography (PET) is an effective tool for the diagnosis, grading, and follow-up of patients affected by GCA involving the aorta and its proximal branches, but the lack of a standardized method for the assessment of vascular inflammation remains a critical issue, potentially leading to misclassification. In our systematic review, including 19 original articles for a total of 442 GCA patients (with or without PMR symptoms) and 535 healthy controls, we described the different qualitative, semiquantitative and combined methods that have been proposed throughout the literature for assessing the presence and grading the severity of GCA-related vascular inflammation on 18F-FDG PET scans, focusing on the diagnostic performance and examining their respective advantages and limitations. The majority of the included studies adopted qualitative methods of PET image analysis, which are less sensitive but more specific than semiquantitative ones. Among the semiquantitative approaches, the aortic-to-blood pool uptake ratio of the aortic arch seems to be the most accurate method.
authors.affiliation: Department of Radiology, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Puppo
authors.affiliation: Nuclear Medicine Unit, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Massollo
authors.affiliation: Department of Radiology, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Paparo
authors.affiliation: Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy.
authors.forename: Dario
authors.initials: D
authors.lastname: Camellino
authors.affiliation: Nuclear Medicine Unit, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Arnoldo
authors.initials: A
authors.lastname: Piccardo
authors.affiliation: Nuclear Medicine Unit, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Mehrdad
authors.initials: M
authors.lastname: Shoushtari Zadeh Naseri
authors.affiliation: Nuclear Medicine Unit, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: Villavecchia
authors.affiliation: Department of Radiology, Department of Diagnostic Imaging, E.O. Ospedali Galliera, Mura della Cappuccine 14, 16128 Genoa, Italy.
authors.forename: Gian Andrea
authors.initials: GA
authors.lastname: Rollandi
authors.affiliation: Research Laboratory and Academic Unit of Clinical Rheumatology, Department of Internal Medicine, University of Genoa, V.le Benedetto XV 6, 16132 Genoa, Italy.
authors.forename: Marco Amedeo
authors.initials: MA
authors.lastname: Cimmino
mesh_terms: D001013:Aorta, Thoracic / Q000000981:diagnostic imaging / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007249:Inflammation / Q000000981:diagnostic imaging* / Q000473:pathology; D011111:Polymyalgia Rheumatica / Q000000981:diagnostic imaging / Q000473:pathology; D049268:Positron-Emission Tomography / Q000379:methods*; D011859:Radiography; D014657:Vasculitis / Q000000981:diagnostic imaging* / Q000473:pathology
chemical_list: D019788:Fluorodeoxyglucose F18