Disease activity and response to therapy monitored by [18F]FDG PET/CT using volume-based indices in IgG4-related disease

Purpose The efficiency of [ 18 F]FDG PET/CT using volume-based indices was evaluated to assess the disease activity and response to therapy in patients with immunoglobulin G4-related disease (IgG4-RD). Methods A total of 17 patients with IgG4-RD were examined with [ 18 F]FDG PET/CT before and during treatment. The lesion boundary was determined using a fixed threshold of standardized uptake value (SUV) ≥ 2.5. The highest maximum SUV (SUVmax) among all affected lesions was calculated for individual patients. We summed metabolic tumor volume (MTV) and total lesion glycolysis (TLG) of each affected lesion to generate a total MTV and total TLG. PET results were compared with those of serum IgG4 and soluble interleukin-2 receptor (sIL-2R) levels. Results The mean number of involved organs per patient was 3.8 as determined by [ 18 F]FDG uptake. The number of involved organs, total MTV and total TLG were significantly correlated with IgG4 ( P = 0.046,