Evaluation of Spleen Glucose Metabolism Using18F-FDG PET/CT in Patients with Febrile Autoimmune Disease.
The purpose of this study was to evaluate the clinical significance of18F-FDG uptake by the spleen in patients with autoimmune disease.Methods:We retrospectively reviewed Severance Hospital's electronic medical records of patients hospitalized for the evaluation of fever who underwent18F-FDG PET/CT. We found 91 patients with autoimmune diseases and 101 patients with localized infection.18F-FDG uptake was assessed by measuring SUV in the spleen and liver. The spleen-to-liver ratio of the SUVmean(SLRmean) was calculated. Clinical and laboratory parameters were collected and evaluated for association with SLRmeanIn-hospital mortality was defined as all-cause mortality during hospital admission for fever.Results:SLRmeanwas significantly higher in autoimmune disease than in localized infectious disease (1.28 ± 0.43 vs. 0.91 ± 0.21,P< 0.001). In autoimmune disease, SLRmeanwas correlated with monocytes, aspartate aminotransferase, alanine aminotransferase, albumin, and ferritin. Analysis of receiver-operating-characteristic curves revealed that in comparison with laboratory parameters, SLRmeanhad the highest performance in differentiating autoimmune from localized infectious disease. Multivariate logistic regression analysis demonstrated that high SLRmeanand low platelets were significantly associated with in-hospital mortality in febrile autoimmune disease.Conclusion:These findings suggest that spleen glucose metabolism is increased in febrile autoimmune disease. Spleen18F-FDG uptake may provide information useful in differentiating febrile autoimmune disease from localized infectious disease and predicting clinical outcomes in febrile autoimmune disease.
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; and.
Sung Soo
SS
Ahn
Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea.
Sang Hyun
SH
Hwang
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; and.
Seung Min
SM
Jung
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; and.
Sang-Won
SW
Lee
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; and.
Yong-Beom
YB
Park
Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea jsksong@yuhs.ac yunmijin@yuhs.ac.
Mijin
M
Yun
Division of Rheumatology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea; and jsksong@yuhs.ac yunmijin@yuhs.ac.
Jason Jungsik
JJ
Song
D000293:Adolescent; D000328:Adult; D000368:Aged; D001327:Autoimmune Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000378:metabolism*; D005260:Female; D005335:Fever of Unknown Origin / Q000000981:diagnostic imaging / Q000209:etiology / Q000378:metabolism*; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics; D005947:Glucose / Q000378:metabolism*; D006801:Humans; D008297:Male; D008657:Metabolic Clearance Rate; D008875:Middle Aged; D057054:Molecular Imaging / Q000379:methods*; D009928:Organ Specificity; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013154:Spleen / Q000000981:diagnostic imaging / Q000378:metabolism*; D014018:Tissue Distribution; D055815:Young Adult
D019788:Fluorodeoxyglucose F18; D005947:Glucose
18F-FDG PET/CT; autoimmune disease; bone marrow; immunometabolism; spleen