Clinical Factors Associated with Time-Specific Distribution of 18F-Fluorodeoxyglucose in Large-Vessel Vasculitis.

Published on Oct 23, 2019in Scientific Reports4.38
· DOI :10.1038/S41598-019-51800-X
Joel S. Rosenblum6
Estimated H-index: 6
,
Kaitlin A. Quinn9
Estimated H-index: 9
(MedStar Georgetown University Hospital)
+ 3 AuthorsPeter C. Grayson27
Estimated H-index: 27
Sources
Abstract
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) can detect vascular inflammation in large-vessel vasculitis (LVV). Clinical factors that influence distribution of FDG into the arterial wall and other tissues have not been characterized in LVV. Understanding these factors will inform analytic strategies to quantify vascular PET activity. Patients with LVV (n = 69) underwent 141 paired FDG-PET imaging studies at one and two hours per a delayed image acquisition protocol. Arterial uptake was quantified as standardized uptake values (SUVMax). SUVMean values were obtained for background tissues (blood pool, liver, spleen). Target-to-background ratios (TBRs) were calculated for each background tissue. Mixed model multivariable linear regression was used to identify time-dependent associations between FDG uptake and selected clinical features. Clinical factors associated with FDG distribution differed in a tissue- and time-dependent manner. Age, body mass index, and C-reactive protein were significantly associated with arterial FDG uptake at both time points. Clearance factors (e.g. glomerular filtration rate) were significantly associated with FDG uptake in background tissues at one hour but were weakly or not associated at two hours. TBRs using liver or blood pool at two hours were most strongly associated with vasculitis-related factors. These findings inform standardization of FDG-PET protocols and analytic approaches in LVV.
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References32
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#1Kaitlin A. Quinn (Georgetown University)H-Index: 9
#2Joel S. Rosenblum (NIH: National Institutes of Health)H-Index: 6
Last. Peter C. Grayson (NIH: National Institutes of Health)H-Index: 27
view all 7 authors...
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#1Sang-Woo Lee (KNU: Kyungpook National University)H-Index: 30
#2Seong-Jang Kim (PNU: Pusan National University)H-Index: 26
Last. Jaetae Lee (KNU: Kyungpook National University)H-Index: 32
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Background The aim of this study is to investigate the performance of F-18 fluorodeoxyglucose positron emission tomography (F-18 FDG PET) or positron emission tomography/computed tomography (PET/CT) for the assessment of disease activity in patients with large vessel vasculitis (LVV) through a meta-analysis.
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#1Eun Hye Park (Seoul National University Hospital)H-Index: 7
#2Eun Young Lee (Seoul National University Hospital)H-Index: 30
Last. Yeong Wook Song (SNU: Seoul National University)H-Index: 57
view all 9 authors...
To evaluate the efficacy and safety of infliximab biosimilar CT-P13 in patients with active Takayasu arteritis (TAK). In this single-center open-label trial, patients with active TAK received CT-P13 at a starting dose of 5 mg/kg at weeks 0, 2, 6, and then every 8 weeks up to week 46. They were followed up until week 54. From week 14 to week 46, patients with inadequate response received increased dose of CT-P13 by 1.5 mg/kg. Concomitant prednisolone was allowed ≤ 10 mg/day. The primary efficacy ...
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#1Kaitlin A. QuinnH-Index: 9
#2Mark A. Ahlman (NIH: National Institutes of Health)H-Index: 21
Last. Peter C. Grayson (NIH: National Institutes of Health)H-Index: 27
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Objectives To assess agreement between interpretation of magnetic resonance angiography (MRA) and 18 F-fluorodeoxyglucose positron emission tomography (PET) for disease extent and disease activity in large-vessel vasculitis (LVV) and determine associations between imaging and clinical assessments. Methods Patients with giant cell arteritis (GCA), Takayasu’s arteritis (TAK) and comparators were recruited into a prospective, observational cohort. Imaging and clinical assessments were performed con...
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#1Berit Dalsgaard Nielsen (AU: Aarhus University)H-Index: 5
#2Lars C. Gormsen (Aarhus University Hospital)H-Index: 31
Last. Ellen-Margrethe Hauge (AU: Aarhus University)H-Index: 13
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Purpose To evaluate the in-treatment diagnostic accuracy of FDG PET/CT in large-vessel giant cell arteritis (LV-GCA) by serial scans before and after a short course of high-dose glucocorticoid treatment.
Source
Large vessel vasculitis (LVV) is defined as a disease mainly affecting the large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists with polymyalgia rheumatica (PMR) in the same patient, since both belong to the same disease spectrum. FDG-PET/CT is a functional imaging technique which is an established tool in oncology, and has also demonstrated a role in the field of inflammatory diseases. Functional FDG-PET combined with anatomical CT ...
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#1Alessandra SorianoH-Index: 17
#2Giulia PazzolaH-Index: 17
Last. Carlo Salvarani (University of Modena and Reggio Emilia)H-Index: 98
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OBJECTIVES: To compare patterns of vascular involvement using 18F-fluorodeoxyglucose-positron emission tomography computed tomography (FDG PET/CT) in patients with giant cell arteritis (GCA) and Takayasu's arteritis (TAK). METHODS: A total of 130 consecutive 18F-FDG PET/CT scans performed during the disease course for evaluating disease activity in 15 GCA and 13 TAK patients were retrospectively examined by two nuclear physicians blinded to clinical data. Standardised uptake values (SUVmax) in 1...
#1Peter C. GraysonH-Index: 27
#2Sara AlehashemiH-Index: 10
Last. Mark A. AhlmanH-Index: 21
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Objectives To assess the clinical value of 18F-flurodeoxyglucose (FDG) positron emission tomography (PET) in a prospective cohort of patients with large-vessel vasculitis (LVV) and disease comparators. Methods Patients with Takayasu's arteritis (TAK) and giant cell arteritis (GCA) were studied, along with a comparator group consisting of patients with hyperlipidemia, diseases that mimic LVV, and healthy controls. Participants underwent clinical evaluation and FDG-PET imaging, and patients with L...
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#1Mark A. Ahlman (NIH: National Institutes of Health)H-Index: 21
#2Davis M. Vigneault (University of Oxford)H-Index: 8
Last. David A. Bluemke (NIH: National Institutes of Health)H-Index: 140
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Introduction 18Fluorodeoxyglucose (FDG) positron emission tomography (PET) uptake in the artery wall correlates with active inflammation. However, in part due to the low spatial resolution of PET, variation in the apparent arterial wall signal may be influenced by variation in blood FDG activity that cannot be fully corrected for using typical normalization strategies. The purpose of this study was to evaluate the ability of the current common methods to normalize for blood activity and to inves...
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#2Alper M. van Sijl (VUmc: VU University Medical Center)H-Index: 10
Last. Ronald BoellaardH-Index: 83
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BACKGROUND: 18F-FDG-PET(/CT) is increasingly used in studies aiming at quantifying atherosclerotic plaque inflammation. Considerable methodological variability exists. The effect of data acquisition and image analysis parameters on quantitative uptake measures, such as standardized uptake value (SUV) and target-to-background ratio (TBR) has not been investigated extensively. OBJECTIVE: The goal of this study was to explore the effect of several data acquisition and image analysis parameters on q...
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The aim of this study is to investigate the influence of sex, age, fat mass, fasting blood glucose level (FBGL), and estimated glomerular filtration rate (eGFR) on blood pool activity in patients with large vessel vasculitis (LVV). Blood pool activity was measured in the superior caval vein using mean, maximum, and peak standardized uptake values corrected for body weight (SUVs) and lean body mass (SULs) in 41 fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) scans...
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#2Tae Joo Jeon (Yonsei University)H-Index: 14
Last. Min Chan Park (Yonsei University)H-Index: 28
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PURPOSE To evaluate whether vascular uptake on 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) during the clinically inactive state of Takayasu arteritis (TAK) is associated with disease relapse. MATERIALS AND METHODS Patients with TAK who underwent 18F-FDG PET/CT during the clinically inactive state of the disease between 2006 and 2019 were included. Clinically inactive disease was defined as a status not fulfilling the National Institutes of Health (NIH...
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Early recognition of giant cell arteritis (GCA) is crucial to avoid the development of ischemic vascular complications, such as blindness. The classic approach to making the diagnosis of GCA is based on a positive temporal artery biopsy, which is among the criteria proposed by the American College of Rheumatology (ACR) in 1990 to classify a patient as having GCA. However, imaging techniques, particularly ultrasound (US) of the temporal arteries, are increasingly being considered as an alternativ...
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#2J P Roth (FAU: University of Erlangen-Nuremberg)H-Index: 1
Last. Francesco MuratoreH-Index: 20
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OBJECTIVES Efficacy evaluation of giant cell arteritis (GCA) treatment is primarily based on non-specific symptoms and laboratory markers. We aimed to assess the change in vascular inflammation in patients with large vessel (LV)-GCA under different treatments using [18F]FDG PET/CT. METHODS Observational study on patients with new-onset, active LV-GCA starting treatment with either prednisolone monotherapy (PRED) or combination with methotrexate (MTX) or tocilizumab (TOC). All patients underwent ...
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#1Ayaz Aghayev (Brigham and Women's Hospital)H-Index: 15
Large vessel vasculitis (LVV) is a non-infectious inflammation of the large vessels, including the aorta and its main branches. Imaging plays an essential role in diagnosing LVV, given the challeng...
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#1Riemer H. J. A. Slart (UMCG: University Medical Center Groningen)H-Index: 57
#2Andor W. J. M. Glaudemans (UMCG: University Medical Center Groningen)H-Index: 41
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With this document, we provide a standard for PET/(diagnostic) CT imaging procedures in cardiovascular diseases that are inflammatory, infective, infiltrative, or associated with dysfunctional innervation (4Is). This standard should be applied in clinical practice and integrated in clinical (multicenter) trials for optimal procedural standardization. A major focus is put on procedures using [18F]FDG, but 4Is PET radiopharmaceuticals beyond [18F]FDG are also described in this document. Whilst the...
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#1Ayaz Aghayev (Brigham and Women's Hospital)H-Index: 15
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Vasculitis, a systemic disease characterised by inflammation of the blood vessels, remains challenging to diagnose and manage. Vessel size has been the basis for classifying systemic vasculitides. Imaging plays a vital role in diagnosing this challenging disease. This review article aims (a) to summarise up-to-date literature in this field, as well as include classification updates and (b) to review available imaging techniques, recent advances, and emphasis on imaging findings to diagnose large...
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#1Amir Emamifar (University of Southern Denmark)H-Index: 7
#2Torkell Ellingsen (University of Southern Denmark)H-Index: 28
Last. Peter Thye-Rønn (University of Southern Denmark)H-Index: 9
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Objective To define the proportions of agreement between fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT), clinical diagnosis, and temporal artery biopsy (TAB) in patients with polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). Furthermore, the association of 18F-FDG PET/CT uptake patterns and clinical presentation of newly diagnosed PMR and GCA was investigated. Methods Eighty patients newly suspected of having PMR, GCA, or concomitant...
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#1Endre KolossváryH-Index: 7
#2György BalázsH-Index: 21
Last. Katalin Farkas (Semmelweis University)H-Index: 3
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According to the nomenclature of the Chapel Hill Consensus Conference, giant-cell arteritis and Takayasu's arteritis belong to the group of large-vessel vasculitis. Recognition of these diseases is primarily based on the clinical assessment and the use of various vascular imaging modalities. With regard to the latter one, significant technological advances have been observed in recent years, which allow not only to make a diagnosis but also to evaluate the extent of the disease and the degree of...
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