title: [Positron emission tomography with (18)F-FDG in the evaluation of patients with rheumatoid arthritis--a systematic review].
abstract: BACKGROUND
  Rheumatoid arthritis (RA) is a disease characterized by inflammation of the synovial membrane. Several authors have investigated the role of positron emission tomography (PET) with fluorine-18 fluorodeoxyglucose ((18)F-FDG) in RA.
  
  
  OBJECTIVE
  To systematically review the current literature on the role of (18)F-FDG PET in the diagnosis, determination of disease activity and assessment of treatment response in patients with RA.
  
  
  METHODS
  Searches were conducted in Medline, Cochrane Library, Lilacs, Pubmed and Scopus in Portuguese, English and Spanish languages, using the keywords "rheumatoid arthritis", "synovitis", "FDG", "PET", "glycolytic metabolism" and "disease activity".
  
  
  RESULTS
  142o articles were initially identified, of which only 40 were related directly to the subject. Twelve original articles and three case reports that met the inclusion criteria were selected.
  
  
  CONCLUSIONS
  The presence of activated macrophages and fibroblasts in pannus are responsible for the intense periarticular uptake of (18)F-FDG. The uptake patterns do not allow the differential diagnosis with other arthritides. The uptake intensity and the number of joints involved are metabolic parameters of disease activity that correlate well with the composite indices. Longitudinal studies of PET have proven useful in assessing the response to treatment with anti-TNF. When performed early, PET can predict the therapeutic response.
  
  
  CONCLUSIONS
  Although the actual role of this new technique for the investigation of RA is not yet established, (18)F-FDG PET is a promising tool in determining the activity and prediction of response to treatment of patients with RA.
authors.affiliation: Faculdade de Medicina, Universidade de Brasília; Centro de Medicina Nuclear do Hospital Universitário de Brasília, Clínica Núcleos e Serviço de PET/CT do Hospital Santa Lúcia, Brasília, DF, Brasil. Electronic address: daltonanjos@unb.br.
authors.forename: Dalton Alexandre
authors.initials: DA
authors.lastname: dos Anjos
authors.affiliation: Serviço de Reumatologia do Hospital Universitário de Brasília, Faculdade de Medicina, Universidade de Brasília, Brasília, DF, Brasil.
authors.forename: Licia Maria Henrique
authors.initials: LM
authors.lastname: da Mota
mesh_terms: D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D019788:Fluorodeoxyglucose F18; D006801:Humans; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals; D016896:Treatment Outcome
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Artrite reumatoide; Fluorine‐18 fluorodeoxyglucose ((18)F‐FDG); Flúor‐18 (FDG‐(18)F); Positron emission tomography (PET); Rheumatoid arthritis; Tomografia por emissão de pósitrons (PET)