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Disease activity and vascular involvement in retroperitoneal fibrosis: first experience with fully integrated 18F-fluorodeoxyglucose positron emission tomography/magnetic resonance imaging compared to clinical and laboratory parameters


1, 2, 3, 4, 5, 6, 7

 

  1. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, Technical University of Munich, Germany. klaus.thuermel@mri.tum.de
  2. Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany.
  3. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, Technical University of Munich, Germany.
  4. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, Technical University of Munich, Germany.
  5. Department of Diagnostic and Interventional Radiology, Klinikum rechts der Isar, Technical University of Munich, Germany.
  6. Department of Nuclear Medicine, Klinikum rechts der Isar, Technical University of Munich, Germany.
  7. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, Technical University of Munich, Germany.

CER9338
2017 Vol.35, N°1 ,Suppl.103
PI 0146, PF 0154
Diagnosis

purchase article

PMID: 27974103 [PubMed]

Received: 13/02/2016
Accepted : 01/07/2016
In Press: 14/12/2016
Published: 20/04/2017

Abstract

OBJECTIVES:
The aim of this study was to evaluate the value of fully integrated [18F]-FDG PET/MRI in the assessment of retroperitoneal fibrosis with regard to disease activity, extent and vascular involvement compared to clinical and laboratory parameters.
METHODS:
Seventeen [18F]-FDG PET/MRI examinations were performed in fourteen patients. Qualitative (visual 4-point scale) and quantitative PET parameters (maximum standardised uptake value, SUVmax; target-background ratio, TBR) as well as RF thickness and volume were correlated to clinical and inflammatory parameters and compared between therapy-naïve patients and patients under immunosuppression. Evidence for associated large-vessel vasculitis was examined. Magnetic resonance angiography (MRA) was performed to detect aneurysms or stenoses. Results. Clinical parameters, C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) only incompletely displayed inflammatory activity and did not correlate with PET/MRI parameters. In 29% (4/17) resp. 50% (8/16) of PET/MRI examinations active disease was detected although CRP resp. ESR were in the normal range. SUVmax, TBR and volume of the retroperitoneal mass differed significantly between therapy-naïve patients and patients under therapy (SUVmax p=0.004, TBR p=0.015, volume p=0.015), whereas thickness of the retroperitoneal mass did not (p=0.406). Large-vessel vasculitis was detected in 21% (3/14) and aortic aneurysms in 14% (2/14) of patients. Vasculitis occurred apart from the site of RF in two patients.
CONCLUSIONS:
Whole body hybrid [18F]-FDG-PET/MRI is superior to clinical and inflammatory parameters in disease activity assessment of RF. There may be substantial disease activity despite inflammatory parameters in the normal range. Associated large-vessel vasculitis and aneurysms may occur apart from the site of RF.

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