title: 18F-fluorodeoxyglucose positron emission tomography and the risk of subsequent aortic complications in giant-cell arteritis: A multicenter cohort of 130 patients.
abstract: Previous studies reported a 2- to 17-fold higher risk of aortic complications (dilation or dissection) in patients with giant-cell arteritis (GCA). We aimed to determine whether or not GCA patients with large-vessel involvement demonstrated by positron emission tomography with F-fluorodeoxyglucose combined with computed tomography (FDG-PET/CT) have a higher risk of aortic complications. We conducted a retrospective multicenter study between 1995 and 2014. Patients were included if they fulfilled at least 3 American College of Rheumatology criteria for GCA, or 2 criteria associated with extratemporal biopsy-proven giant-cell vasculitis; they underwent at least 1 FDG-PET/CT scan at diagnosis or during follow-up; and the morphology of the aorta was assessed by medical imaging at diagnosis. Patients with an aortic complication at the time of diagnosis were excluded. Of the 130 patients included [85 women (65%), median age 70 (50-86)], GCA was biopsy proven in 77 (59%). FDG-PET/CT was performed at diagnosis in 63 (48%) patients and during the follow-up period in the 67 (52%) remaining patients. FDG-PET/CT was positive in 38/63 (60%) patients at diagnosis and in 31/67 (46%) patients when performed during follow-up (P = NS). One hundred four patients (80%) underwent at least 1 morphological assessment of the aorta during follow-up. Nine (9%) patients developed aortic complications (dilation in all and dissection in 1) at a median time of 33 (6-129) months after diagnosis. All of them displayed large-vessel inflammation on previous FDG-PET/CT. A positive FDG-PET/CT was significantly associated with a higher risk of aortic complications (P = 0.004).In our study, a positive FDG-PET/CT was associated with an increased risk of aortic complications at 5 years.
authors.affiliation: aDepartment of Internal Medicine, Caen University Hospital, Basse-Normandie University bDepartment of Internal Medicine, Limoges University Hospital cDepartment of Internal Medicine, Lille University Hospital dBiostatistics and Clinical Research Unit, Caen University Hospital eDepartment of Internal Medicine, Bayeux Hospital fDepartment of Internal Medicine, Lisieux Hospital gDepartment of Nuclear Medicine, Lille University Hospital hDepartment of Nuclear Medicine, Caen University Hospital, Normandie University France.
authors.forename: Hubert
authors.initials: H
authors.lastname: de Boysson
authors.forename: Eric
authors.initials: E
authors.lastname: Liozon
authors.forename: Marc
authors.initials: M
authors.lastname: Lambert
authors.forename: Jean-Jacques
authors.initials: JJ
authors.lastname: Parienti
authors.forename: Nicolas
authors.initials: N
authors.lastname: Artigues
authors.forename: Loïk
authors.initials: L
authors.lastname: Geffray
authors.forename: Jonathan
authors.initials: J
authors.lastname: Boutemy
authors.forename: Yann
authors.initials: Y
authors.lastname: Ollivier
authors.forename: Gwénola
authors.initials: G
authors.lastname: Maigné
authors.forename: Kim
authors.initials: K
authors.lastname: Ly
authors.forename: Damien
authors.initials: D
authors.lastname: Huglo
authors.forename: Eric
authors.initials: E
authors.lastname: Hachulla
authors.forename: Pierre-Yves
authors.initials: PY
authors.lastname: Hatron
authors.forename: Achille
authors.initials: A
authors.lastname: Aouba
authors.forename: Alain
authors.initials: A
authors.lastname: Manrique
authors.forename: Boris
authors.initials: B
authors.lastname: Bienvenu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001018:Aortic Diseases / Q000000981:diagnostic imaging* / Q000209:etiology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D013700:Giant Cell Arteritis / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals; D012189:Retrospective Studies
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18