Relapsing polychondritis detected in PET/CT

Czepczyński, Rafał; Guzikowska-Ruszkowska, Izabela; Wyszomirska, Anna

doi:10.1007/s00259-012-2128-6

Cited by 12 publications

(4 citation statements)

References 3 publications

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“…These findings suggest that PET/CT is a promising radiological tool in monitoring treatment response and disease progression. However, because there is no agreement regarding the duration of corticosteroid treatment, there is no consensus regarding the use of PET/CT to optimise corticosteroid strategies, although some studies have revealed its potential value [10–16]. The interval for PET/CT scans after corticosteroid therapy remains unclear, as it has been reported to range from 1 month to 13 months [10–12, 14, 21].…”

Section: Discussionmentioning

confidence: 99%

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

Zeng

Chen

et al. 2019

Arthritis Res Ther

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Background18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a promising tool for diagnosing relapsing polychondritis (RP). However, its usefulness in assessing RP with airway involvement is unknown.ObjectiveThis study aimed to further evaluate and confirm the potency of 18F-FDG PET/CT in diagnosing RP with airway involvement and monitoring response to steroid-based therapy.MethodsA total of 30 patients from a dedicated respiratory centre, diagnosed with RP in accordance with McAdam, Damiani or Levine criteria, were included in this study. All patients underwent baseline 18F-FDG PET/CT, and 10 patients underwent second scans after 2.5–15 months of steroid-based therapy. Visual scores (VS) and maximal standard uptake values (SUVmax) were analysed.ResultsIn the initial scan, 83.3% (25/30) of patients were found to have FDG uptake in more than one cartilage. The median VS and SUVmax in the cartilages were 3 (range, 1–3) and 3.8 (range, 1.9–17.9), respectively. Positive rates for PET/CT-guided biopsy in nasal, auricular, and tracheal/bronchial cartilages were 100% (5/5), 88.9% (8/9), and 10.5% (2/19), respectively, but the positive biopsy rate in the auricular cartilage was 92.3% (12/13) even without PET/CT assessment. Based on biopsy-proven sites, the sensitivity of PET/CT was 55.6%, and the specificity was 5.3%. Compared with the baseline scan, the second scan showed much lower median VS (2 vs 3, respectively; p < 0.0001) and SUVmax (2.9 vs 3.8, respectively; p < 0.001). Of 10 patients who underwent second PET/CT, 8 had complete therapeutic response, while 2 had partial response.Conclusion18F-FDG PET/CT assists in identifying multiple cartilage involvement in RP, but it seems neither a sensitive nor specific modality in diagnosing RP with airway involvement. Moreover, PET/CT has limited utility in locating biopsy sites and monitoring therapeutic response to corticosteroids.

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Section: Discussionmentioning

confidence: 99%

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

Zeng

Chen

et al. 2019

Arthritis Res Ther

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“…The use of FDG-PET to aid diagnosis of RP has also previously been described by Geeter and Vandecasteele,3 Sato et al 4 and Czepczynski et al 5. The mainstay of current medical therapy is immunosuppression (eg, corticosteroids, methotrexate, cyclophosphamide, azathioprine and mycophenalate mofetil) 1 6.…”

Section: Discussionmentioning

confidence: 85%

Positron emission tomography aids diagnosis of relapsing polychondritis

et al. 2014

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A 39-year-old man presented to the hospital in April 2011 with a 2-month history of tonsillitis, night sweats, fatigue, weight loss, shortness of breath on exertion and a dry cough. He was a non-smoker, previously fit and well with no regular medication. Examination of the respiratory, cardiovascular and gastrointestinal systems was normal; he appeared generally well. C reactive protein and erythrocyte sedimentation rate were raised. A CT of the thorax showed mediastinal thickening and mediastinal lymphadenopathy. Whole body (18)F-fluorodeoxyglucose positron emission tomography showed diffuse tracheobronchial activity. Tracheal and lymph node biopsies showed non-specific features. Lung function tests showed an obstructive picture. A diagnosis of relapsing polychondritis was made. Immunosuppressive treatment was started, initially with oral methotrexate and prednisolone, later progressing to intravenous methylprednisolone and intravenous cyclophosphamide. Repeat bronchoscopy showed improvement in inflammation; however, the patient's symptoms were not improved. The patient's symptoms and lung function currently remain stable on maintenance oral prednisolone.

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“…A total of 18 articles [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] , involving 29 cases, were identi ed that reported the diagnosis of RP using PET/CT(Table 1). Thus, a total of 32 cases of RP, diagnosed using FDG PET/CT, have been reported, including the three cases described in the present study.…”

Section: Clinical Characteristics and Pet/ct Ndings On Casementioning

confidence: 99%

“…As of December 2019, the author searched the pubmed database for titles containing "relapsing polychondritis" and "PET/CT" or "PET-CT" keywords. A total of 19 related reports were detected, including 29 cases of RP [5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23] , indicating that it is still a rare disease. The reported cases are mostly clinical collapse of the bridge of the nose and auricle, when severe respiratory symptoms suggest cartilage involvement, or only when cartilage biopsy is performed.…”

Section: Clinical Characteristics and Pet/ct Ndings On Casementioning

confidence: 99%

Value of 18 F-FDG PET/CT for early diagnosis and treatment monitoring of relapsing polychondritis

Liu

Fan

Zhou

et al. 2023

Preprint

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Relapsing polychondritis (RP) is a rare autoimmune disease. Few studies have reported the value of 18F-fluorodeoxyglucose positron emission-computed tomography (18F-FDG-PET/CT) for diagnosis, guiding biopsy and treatment monitoring of RP. 18F-FDG-PET/CT in assessing RP presenting fever of unknown origin (FUO) is not yet reported. To evaluate of 18F-fluorodeoxyglucose positron emission-computed tomography (18F-FDG-PET/CT) for early diagnosis, guiding biopsy and treatment monitoring of relapsing polychondritis (RP), especially for the patient of RP presenting FUO. Consistent with 32 cases had been underwent 18F-FDG-PET/CT scanning, which showed multiple moderately 18F-FDG uptake in the involvement of multiple organs, including the nose, throat, trachea, bronchi, cost cartilage and joint cartilages (SUVmax distribution was 1.93–13.03; mean, 5.02). 50% (16/32) patients were used for PET/CT re-examination after treatment, which revealed that 93.8% (15/16) of patients with RP had decreased obviously for 18F-FDG uptake, with 37.6% (6/16) in decreased substantially and 56.2% (9/16) for disappeared, respectively. The time to diagnosis in these cases was 4.2 months, obviously shorter than the average diagnosis time (20months), showing earlier than conventional method. In addition, biopsies were performed in 56.3% (18/32) of all patients; 94.4% (17/18) cases were positive, which showed useful for targeting biopsy sites. 62.5% (20/32) of all patients presenting FUO had been early diagnosed using 18F-FDG-PET/CT. Treatment monitoring of RP, especially for the patient presenting FUO. It is of great value for monitoring the activity of inflammatory, and guiding the selection of a biopsy site.

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Relapsing polychondritis detected in PET/CT

Cited by 12 publications

References 3 publications

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

Positron emission tomography aids diagnosis of relapsing polychondritis

Value of 18 F-FDG PET/CT for early diagnosis and treatment monitoring of relapsing polychondritis

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