The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment
18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-li...
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| Veröffentlicht in: | Contrast media and molecular imaging 2019-01, Vol.2019 (2019), p.1-8 |
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| creator | Pirilä, Laura Kemppainen, Jukka Roivainen, Anne Nuutila, Pirjo Seppänen, Marko Kajander, Sami Mali, Markku Hohenthal, Ulla Salomäki, Soile P. Taimen, Kirsi Palomäki, Antti |
| description | 18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis. |
| doi_str_mv | 10.1155/2019/9157637 |
| format | Article |
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We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.</description><identifier>ISSN: 1555-4309</identifier><identifier>EISSN: 1555-4317</identifier><identifier>DOI: 10.1155/2019/9157637</identifier><identifier>PMID: 31531005</identifier><language>eng</language><publisher>Cairo, Egypt: Hindawi Publishing Corporation</publisher><subject>Arthritis ; Blood vessels ; C-reactive protein ; Classification ; Clinical Study ; Computed tomography ; Diagnosis ; Drug dosages ; Drugs ; Family medical history ; Feasibility studies ; Fluorine isotopes ; Glucocorticoids ; Inflammation ; Laboratories ; Medical imaging ; Nuclear medicine ; Patients ; Positron emission ; Positron emission tomography ; Prednisolone ; Rheumatism ; Rheumatology ; Studies ; Tomography ; Vasculitis</subject><ispartof>Contrast media and molecular imaging, 2019-01, Vol.2019 (2019), p.1-8</ispartof><rights>Copyright © 2019 Kirsi Taimen et al.</rights><rights>Copyright © 2019 Kirsi Taimen et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. http://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2019 Kirsi Taimen et al. 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><orcidid>0000-0002-4006-7977 ; 0000-0002-8381-2463</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735179/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6735179/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,27903,27904,53769,53771</link.rule.ids></links><search><contributor>Ferro-Flores, Guillermina</contributor><contributor>Guillermina Ferro-Flores</contributor><creatorcontrib>Pirilä, Laura</creatorcontrib><creatorcontrib>Kemppainen, Jukka</creatorcontrib><creatorcontrib>Roivainen, Anne</creatorcontrib><creatorcontrib>Nuutila, Pirjo</creatorcontrib><creatorcontrib>Seppänen, Marko</creatorcontrib><creatorcontrib>Kajander, Sami</creatorcontrib><creatorcontrib>Mali, Markku</creatorcontrib><creatorcontrib>Hohenthal, Ulla</creatorcontrib><creatorcontrib>Salomäki, Soile P.</creatorcontrib><creatorcontrib>Taimen, Kirsi</creatorcontrib><creatorcontrib>Palomäki, Antti</creatorcontrib><title>The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment</title><title>Contrast media and molecular imaging</title><description>18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.</description><subject>Arthritis</subject><subject>Blood vessels</subject><subject>C-reactive protein</subject><subject>Classification</subject><subject>Clinical Study</subject><subject>Computed tomography</subject><subject>Diagnosis</subject><subject>Drug dosages</subject><subject>Drugs</subject><subject>Family medical history</subject><subject>Feasibility studies</subject><subject>Fluorine isotopes</subject><subject>Glucocorticoids</subject><subject>Inflammation</subject><subject>Laboratories</subject><subject>Medical imaging</subject><subject>Nuclear medicine</subject><subject>Patients</subject><subject>Positron emission</subject><subject>Positron emission 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Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Pirilä, Laura</au><au>Kemppainen, Jukka</au><au>Roivainen, Anne</au><au>Nuutila, Pirjo</au><au>Seppänen, Marko</au><au>Kajander, Sami</au><au>Mali, Markku</au><au>Hohenthal, Ulla</au><au>Salomäki, Soile P.</au><au>Taimen, Kirsi</au><au>Palomäki, Antti</au><au>Ferro-Flores, Guillermina</au><au>Guillermina Ferro-Flores</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment</atitle><jtitle>Contrast media and molecular imaging</jtitle><date>2019-01-01</date><risdate>2019</risdate><volume>2019</volume><issue>2019</issue><spage>1</spage><epage>8</epage><pages>1-8</pages><issn>1555-4309</issn><eissn>1555-4317</eissn><abstract>18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.</abstract><cop>Cairo, Egypt</cop><pub>Hindawi Publishing Corporation</pub><pmid>31531005</pmid><doi>10.1155/2019/9157637</doi><tpages>8</tpages><orcidid>https://orcid.org/0000-0002-4006-7977</orcidid><orcidid>https://orcid.org/0000-0002-8381-2463</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Arthritis Blood vessels C-reactive protein Classification Clinical Study Computed tomography Diagnosis Drug dosages Drugs Family medical history Feasibility studies Fluorine isotopes Glucocorticoids Inflammation Laboratories Medical imaging Nuclear medicine Patients Positron emission Positron emission tomography Prednisolone Rheumatism Rheumatology Studies Tomography Vasculitis |
| title | The Clinical Impact of Using 18F-FDG-PET/CT in the Diagnosis of Suspected Vasculitis: The Effect of Dose and Timing of Glucocorticoid Treatment |
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