Aortitis in giant cell arteritis: diagnosis with FDG PET/CT and agreement with CT angiography

作者：Hommada Mona; Mekinian Arsene; Brillet Pierre Yves; Abad Sebastien; Larroche Claire; Dhote Robin; Fain Olivier; Soussan Michael^*

来源：Autoimmunity Reviews, 2017, 16(11): 1131-1137.

DOI：10.1016/j.autrev.2017.09.008

• FDG PET/CT
• Giant cell arteritis
• Aortitis
• CT angiography
• Large vessel vasculitis

Objectives: To assess the detection rate of aortitis in giant cell arteritis (GCA) with fluorodeoxyglucose positron emission tomography/computed tomography (PET) and to compare the findings with CT angiography (CTA).
Methods: Fifty-two GCA patients and 27 controls were included. GCA patients had a PET scan at diagnosis (35/52) or during relapse (17/52). Concomitant CTA was performed in 35/52 patients. Aortitis was defined as FDG uptake higher than the liver for PET and wall thickness 3 mm for CFA Agreement between PET and CFA was evaluated by the kappa coefficient and Spearman correlation coefficient.
Results: Aortitis was diagnosed using PET in 40% (14/35) of patients at diagnosis and in 0% of controls (0/27). Agreement was perfect between PET and CT at a patient-based level, and very good at a vascular segment based level (kappa: 0.72 to 1). PET was positive in 35% (6/17) of patients scanned during GCA relapse, showing aortitis (n = 4) and/or articular uptake (n = 4). Discrepancies between PET and CT were observed only in relapsing GCA (n = 3). Correlation between the maximum standardized uptake value and wall thickness was moderate at diagnosis (r: 0.57 to 0.7) and not statistically significant during relapse.
Conclusions: The detection rate of aortitis in GCA patients using PET is 40%, approximately in the range of CTA rates, suggesting that the two techniques have similar sensitivity. PET seems valuable in relapsing GCA, allowing the detection of vascular and articular activities.

• 出版日期2017-11