title: [18F]fluorodeoxyglucose uptake as a predictor of large joint destruction in patients with rheumatoid arthritis.
abstract: The present retrospective study investigated the relationship between [(18)F]fluorodeoxyglucose-positron emission tomography (FDG-PET) findings and subsequent progression of joint destruction on plain X-ray. Nineteen rheumatoid arthritis (RA) patients (59 joints) who underwent FDG-PET and whose joints could be evaluated on plain X-ray 5 years later were included in this retrospective investigation. The relationship between the standardized uptake value (SUV) on FDG-PET and Larsen grade progression on plain X-ray was investigated for each joint. Factors related to progression of joint destruction were also investigated. Joints with advanced joint destruction (Larsen grades IV and V) on X-ray imaging at the time of FDG-PET were excluded. On initial plain X-ray images taken at the time of FDG-PET, a significant correlation was observed between the initial SUV of each joint and the progression of joint destruction 5 years later (R = 0.47, P < 0.01). Significant correlations between the SUV and progression of joint destruction were observed in both load-bearing (R = 0.52, P < 0.01) and non-load-bearing joints (R = 0.52, P < 0.01). On logistic regression analysis, higher SUV and lower prednisolone dose were associated with greater risk of progressive joint destruction (P < 0.05). On receiver operating characteristics curve analysis, the optimum threshold for identifying preceding joint destruction was an SUVmean of 1.33. In RA joints, FDG uptake was seen mostly by inflammatory cells; therefore, FDG uptake reflected joint inflammation. Additionally, the activity seen on FDG-PET might be associated with future radiographic changes in RA patients.
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan. yukioyone@ybb.ne.jp.
authors.forename: Yukio
authors.initials: Y
authors.lastname: Yonemoto
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Okamura
authors.affiliation: Department of Rheumatology, Isesaki Fukushima Hospital, Isesaki, Gunma, Japan.
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Takeuchi
authors.affiliation: Department of Orthopaedic Surgery, Inoue Hospital, Takasaki, Gunma, Japan.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Kaneko
authors.affiliation: Department of Physical Therapy, Takasaki University of Health and Welfare, Takasaki, Gunma, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Chisa
authors.initials: C
authors.lastname: Okura
authors.affiliation: Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Maebashi, Gunma, Japan.
authors.forename: Yoshito
authors.initials: Y
authors.lastname: Tsushima
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, 3-39-22, Showa-machi, Maebashi, Gunma, 371-8511, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000000981:diagnostic imaging* / Q000188:drug therapy; D018450:Disease Progression; D005260:Female; D019788:Fluorodeoxyglucose F18; D033023:Foot Joints / Q000000981:diagnostic imaging*; D050823:Hand Joints / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008727:Methotrexate / Q000627:therapeutic use; D008875:Middle Aged; D011239:Prednisolone / Q000627:therapeutic use; D011859:Radiography; D011877:Radionuclide Imaging; D012189:Retrospective Studies
chemical_list: D018501:Antirheumatic Agents; D019788:Fluorodeoxyglucose F18; D011239:Prednisolone; D008727:Methotrexate
keywords: FDG-PET; Joint destruction; Larsen grade; Rheumatoid arthritis; Standardized uptake value