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Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in polymyalgia rheumatica: an observational study

1, 2, 3, 4, 5, 6, 7, 8, 9, 10

 

  1. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  2. Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  3. Service de Pneumologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  4. Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  5. Service de Médecine Nucléaire, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  6. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  7. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  8. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  9. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France.
  10. Service de Rhumatologie, AP-HP, Hôpital Bichat-Claude Bernard, Paris, France. sebastien.ottaviani@aphp.fr

CER16141
2023 Vol.41, N°7
PI 1456, PF 1462
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PMID: 36533978 [PubMed]

Received: 16/08/2022
Accepted : 17/10/2022
In Press: 15/12/2022
Published: 10/07/2023

Abstract

OBJECTIVES:
Polymyalgia rheumatica (PMR) is an inflammatory disease with a diagnosis that is sometimes difficult to establish. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) might be helpful. We analysed the usefulness of 18F-FDG PET/CT for the diagnosis of PMR.
METHODS:
This was an observational retrospective study of individuals with PMR who underwent 18F-FDG PET/CT and a control group. We assessed clinical and 18F-FDG PET/CT characteristics. Sixteen sites were studied. The number of sites with significant FDG uptake, the mean maximum standardised uptake value (SUVmax) and the highest SUVmax value were assessed for each patient.
RESULTS:
Data for 123 patients with PMR (37 with corticosteroids [CSTs] use) were analysed; 85 had new-onset PMR. As compared with the 75 controls, patients with new-onset PMR had higher mean ± SD number of sites with significant FDG uptake (11.3 ± 3.3 vs. 0.9 ± 1.1, p<0.001) and higher SUVmax scores (p<0.001). A cut-off of 5 hypermetabolic sites provided sensitivity of 96.5% and specificity 100%. For the total SUVmax score, a cut-off of 3 had the best sensitivity (92.6%) and specificity (86.1%). As compared with PMR patients using CSTs, those who were CST-naive had significantly higher CRP level (p<0.001), number of sites with significant FDG uptake (p<0.001) and SUVmax scores (p<0.01). In contrast, large-vessel vasculitis was more frequent in patients receiving CSTs than CST-naive patients (27% vs. 8%, p<0.01).
CONCLUSIONS:
The number of hypermetabolic sites or SUVmax quantification might be useful for PMR diagnosis, and CSTs might affect the results of 18F-FDG PET/CT.

DOI: https://doi.org/10.55563/clinexprheumatol/kqyki5

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