18F-FDG PET molecular imaging: A relevant tool to investigate chronic inflammatory rheumatisms in clinical practice?

Abstract

18F-Labeled Fluorodeoxyglucose-Positron Emission Tomography (18F-FDG PET) is a molecular imaging tool commonly used in practice for the assessment of many cancers. Thanks to its properties, its use has been progressively extended to numerous inflammatory conditions, including chronic inflammatory rheumatism (CIR) such as rheumatoid arthritis (RA), spondylarthritis (SpAs) and polymyalgia rheumatica (PMR). 18F-FDG PET is currently not recommended for the diagnostic of CIRs. However, this whole-body imaging tool has emerged in clinical practice, providing a general overview of systemic involvement occurring in CIRs. Numerous studies have highlighted the capacity of 18F-FDG PET to detect articular and extra articular involvements in RA and PMR. However, the lack of specificity of 18F-FDG limits its use for diagnosis purpose. Finally, the key question is the definition of the best way to integrate this whole-body imaging tool in the patient’s management workflow.

Case report: diagnosis and treatment of advanced high-grade serous ovarian carcinoma aided by 68Ga-FAPI PET/MR scan

“…18 F-FDG is one of the tracers that were first introduced into clinical practice, and for years it has been one of the most widely used PET tracers in cancer scanning [11,12]. Although 18 F-FDG imaging has optimal performances in most cases, it has several drawbacks including false positives due to non-cancerous tissue with increased metabolic activity, false negatives due to cancer cells with low metabolic rates, nonspecificity caused by inflammation and infection and limitations in detecting certain types of cancer such as prostate cancer, brain tumors or bone tumors [13,14]. 68 Ga-FAPI was developed and introduced for clinical use around 2017-2018.…”