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Large-vessel vasculitis

 

18F-FDG PET/MRI compared with clinical and serological markers for monitoring disease activity in patients with aortitis and chronic periaortitis


1, 2, 3, 4, 5, 6, 7, 8

 

  1. Department of Nuclear Medicine, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, and Department of Radiology, University Hospital Regensburg, Germany. ingo.einspieler@ukr.de
  2. Department of Nuclear Medicine, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.
  3. Department of Nuclear Medicine, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.
  4. Department of Vascular Surgery, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.
  5. Department of Medical Statistics and Epidemiology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.
  6. Department of Radiology, University Hospital Regensburg, Germany.
  7. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.
  8. Department of Nephrology and Rheumatology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany.

CER13078
2020 Vol.38, N°2 ,Suppl.124
PI 0099, PF 0106
Large-vessel vasculitis

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PMID: 32242814 [PubMed]

Received: 06/01/2020
Accepted : 11/03/2020
In Press: 02/04/2020
Published: 21/05/2020

Abstract

OBJECTIVES:
We compared the diagnostic value of fully integrated 18F-FDG PET/MRI to that of clinical and serological markers for monitoring disease activity in patients with aortitis/chronic periaortitis (A/CPA) during immunosuppressive therapy.
METHODS:
Patients positive for A/CPA at the initial and at least 2 consecutive PET/MRI studies were included for retrospective analysis. Imaging (qualitative and quantitative analysis), clinical, and serologic (C-reactive protein, erythrocyte sedimentation rate) assessments were determined at each visit, and their findings compared. Differences in various PET/MRI parameters, clinical symptoms, and serologic markers during therapy between first and second visits were tested for statistical significance. Spearman’s rank correlation coefficient was calculated to relate imaging to serologic marker changes between the first 2 visits.
RESULTS:
Serial assessments were performed in 12 patients with A/CPA, over 34 visits. PET/MRI suggested active disease in 22/34 (64.7%) studies, whereas clinical assessment and serological analysis were positive in only 18/34 (52.9%) and 17/34 (50%) cases, respectively. Disease activity assessment differed between PET/MRI, and clinical and serological markers, in 8/34 (23.5%) and 9/34 (26.5%) cases, respectively. Imaging and serologic parameters (p < 0.009) and clinical symptoms (p = 0.063) predominantly improved at the second visit. Changes from the first to the second visit were not correlated between PET/MRI and serologic markers.
CONCLUSIONS:
Fully integrated 18F-FDG PET/MRI provides a comprehensive imaging approach with data on vascular/perivascular inflammation that is complementary to clinical and laboratory assessments. This highlights the potential value of imaging-based disease activity monitoring, which might have a crucial impact on clinical management in patients with A/CPA.

Rheumatology Article