The role of ¹⁸F‐fluorodeoxyglucose–positron emission tomography in the assessment of disease activity in patients with Takayasu arteritis

Abstract

Objective. The assessment of disease activity in Takayasu arteritis (TA) is difficult in clinical situations because clinical symptoms and laboratory parameters do not always reflect the actual inflammation of the arterial wall. We undertook this study to comprehensively investigate the role of 18 F-fluorodeoxyglucosepositron emission tomography (FDG-PET) in the assessment of disease activity in patients with TA.Methods. We performed a retrospective chart review of 53 FDG-PET scans in 38 patients with TA. We measured 18 F-fluorodeoxyglucose ( 18 F-FDG) accumulation in the vascular wall of the large vessel using semiquantitative (visual grade) and quantitative (standard uptake value intensity) analyses. Clinical disease activity was evaluated based on the National Institutes of Health criteria for active TA, and erythrocyte sedimentation rates (ESRs) and C-reactive protein (CRP) levels were measured.

Contrast‐Enhanced Ultrasound of the Carotid Artery in Patients With Large Vessel Vasculitis: Correlation With Positron Emission Tomography Findings

“…Previous studies have reported the utility of the 18 F-FDG PET/CT scan in the assessment of disease activity in patients with LVV (27)(28)(29)(30)(31)(32). Notwithstanding the lack of standardization and heterogeneous reference standards, 18 F-FDG PET/ CT has a substantial sensitivity and specificity for the diagnosis of both TAK and GCA (4,5).…”

“…In LVV, correlation of PET findings with clinical symptoms or laboratory inflammatory markers is not always consistent (27). However, recent studies have observed a correlation between vascular 18 F-FDG uptake and clinical disease activity and/or acute-phase reactants (29,31). Tezuka et al (31) showed that 18 F-FDG PET/CT was useful for detection of active inflammation not only in patients with active TAK before treatment, but also in relapsing patients receiving immunosuppressive agents.…”

Inflammatory diseases of the aorta

“…At this stage, aortic involvement is already considerable. As in large vessel GCA, aortitis may be fi rst diagnosed by PET [30].…”

Myocardial Positron Emission Tomography/Computed Tomography Scan Revealing Right Coronary Artery Involvement in Large Vessel Vasculitis

“…FDG-PET has been used in the diagnosis of large vessel vasculitis and, although in part still debated, has a promising role in monitoring disease activity and response to treatment 4,5,6 . Coronary CTA has been developed into a clinically useful method for visualization of coronary artery stenosis with high negative predictive value, but the evaluation of stenosis is often uncertain 7 .…”