title: (18)F-FDG PET/CT for the detection of large vessel vasculitis in patients with polymyalgia rheumatica.
abstract: OBJECTIVE
  Polymyalgia rheumatica (PMR) may present together with large vessel vasculitis (LVV), and frequently requires a more intensive therapy. The aim of the study was to evaluate the impact of (18)F-FDG PET/CT in the diagnosis and management of LVV associated to PMR.
  
  
  METHODS
  This prospective study included 40 consecutive patients (27 women/13 men, 68.10±10.27 years) with PMR and suspicion of associated LVV submitted for (18)F-FDG PET/CT. A PET/CT scan was obtained 180 min after (18)F-FDG intravenous injection. A visual analysis was performed on the images. Five vascular regions were evaluated: supra-aortic trunks (SAT), thoracic aorta (TA), abdominal aorta (AA), iliac arteries (IA), and femoral/tibioperoneal arteries (FTA). The intensity of uptake was graded from 0 to 3. A final diagnosis of LVV was established in 26/40 patients (65%).
  
  
  RESULTS
  In the 26 patients with a diagnosis of LVV, the highest intensity of (18)F-FDG uptake was observed in the TA, SAT, and FTA. All of these patients showed uptake at the TA, with grade 2 and 3 in most cases. In 4 of the 14 patients without LVV, no uptake was observed in any vascular region, and in the other 10 patients only a grade 1 uptake was observed in 1 or to 2 territories. Out of the 20 treated LVV patients, (18)F-FDG PET/CT led to a therapeutic change in 17 (85%).
  
  
  CONCLUSIONS
  (18)F-FDG PET/CT was useful in identifying patients with LVV associated to PMR. The detection of vascular inflammation had an important impact, and led to a change of treatment in a high percentage of patients with LVV.
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Lavado-Pérez
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain. Electronic address: mimartinez@humv.es.
authors.forename: I
authors.initials: I
authors.lastname: Martínez-Rodríguez
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Martínez-Amador
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: I
authors.initials: I
authors.lastname: Banzo
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Quirce
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Jiménez-Bonilla
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: De Arcocha-Torres
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: Z
authors.initials: Z
authors.lastname: Bravo-Ferrer
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Jiménez-Alonso
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: López-Defilló
authors.affiliation: Department of Rheumatology, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: R
authors.initials: R
authors.lastname: Blanco
authors.affiliation: Department of Rheumatology, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: M A
authors.initials: MA
authors.lastname: González-Gay
authors.affiliation: Department of Nuclear Medicine, Molecular Imaging Group (IDIVAL), Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
authors.forename: J M
authors.initials: JM
authors.lastname: Carril
mesh_terms: D000368:Aged; D001025:Aortitis / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology; D001799:Blood Sedimentation; D005260:Female; D005462:Fluorine Radioisotopes / Q000493:pharmacokinetics; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011111:Polymyalgia Rheumatica / Q000150:complications*; D000072078:Positron Emission Tomography Computed Tomography; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D016037:Single-Blind Method; D014018:Tissue Distribution; D014657:Vasculitis / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: (18)F-FDG PET/CT; (18)F-FDG PET/TAC; Aortitis; Arteritis de células gigantes; Giant cell arteritis; Large vessel vasculitis; Polimialgia reumática; Polymyalgia rheumatica; Positron emission tomography; Tomografía por emisión de positrones; Vasculitis de grandes vasos