PET/CT imaging in systemic lupus erythematosus

Abstract

Systemic lupus erythematosus (SLE) is the classical immune-complex disease. Involvement of vital organs, particularly the kidneys and brain, accounts for significant morbidity and mortality. A number of imaging tools are currently available for evaluation of inflammatory conditions. By targeting the increased glucose uptake of infiltrating granulocytes and tissue macrophages, positron emission tomography with fluorine-18 fluorodeoxyglucose ([(18) F]FDG PET/CT) has been shown to delineate inflammation with high sensitivity. Because activated lymphocytes have increased glucose metabolism, [(18) F]FDG PET has been successfully used to visualize large concentrations of these cells in lymphoid organs where antigen presentation and lymphocyte activation occur. Widespread increased FDG uptake in lymph nodes of patients with active SLE, as well as increased thymic uptake, has been described. The most prevalent and dramatic PET/CT finding in neuropsychiatric SLE (NP-SLE) patients is parieto-occipital hypometabolism. In conclusion, PET/CT has become an excellent ancillary tool to assess disease activity and prognosis in SLE patients.

Estudio prospectivo para determinar el valor real de la captación de 18F-FDG mesentérica en pacientes oncológicos: ¿paniculitis mesentérica inflamatoria o tumoral?

“…En la actualidad numerosos estudios de investigación van dirigidos a asignar al PET un nuevo enfoque y una nueva utilidad diagnóstica en el campo de la patología infecciosa e inflamatoria, convirtiéndose en el nuevo paradigma en patologías como la endocarditis infecciosa, vasculitis de grandes vasos, enfermedad inflamatoria intestinal, infección de prótesis vasculares, fiebre de origen desconocido u osteomielitis crónica, entre otros [13][14][15][16][17][18] .…”

“…La visualización de las lesiones inflamatorias no solo se basa en la presencia de células inmunes, la captación del trazador en realidad requiere de la activación de estas células inmunes [13][14][15][16][17][18] . La inflamación resulta entonces en una respuesta hipermetabólica y un requerimiento obligado de glucosa en apoyo al metabolismo celular.…”

Neuropsychiatric systemic lupus erythematosus and cognitive dysfunction: The MRL-lpr mouse strain as a model

“…As an illustration, more than 40% of NPSLE patients show normal MRI scans [14,55] and even if brain imaging reveals abnormalities (e.g. cerebral atrophy, subcortical white matter lesions, regional neurometabolic dysfunctions, hypoperfusion), these findings are often nonspecific, some of them being also observed in patients without NP manifestations and in the general population after mid-adult life [55][56][57][58]. Brain atrophy, which is however quite often reported [48] has been proposed to reflect progressive neuronal injury and demyelination.…”

Hypermetabolic Lymphadenopathy on PET CT in Systemic Lupus Erythematosus: A CaseReport

“…The ability of PET scan to qualitatively characterize the degree of systemic inflammation and organ involvement have been previously described for SLE [8]. Mechanistically, activated lymphocytes exhibit higher degrees of glucose metabolism, concentrating in lymphoid tissues, as seen on PET scan via a radioactively labeled tracer [9].…”