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PET-CT and large vessel vasculitis

Daniela Grünholz, María Paz Poblete, Loreto Ovalle, Eduardo Wainstein, Gloria Rubio, María Manríquez, Karin Kalbhenn
Large vessel vasculitis and particularly Temporal Arteritis are systemic diseases that may affect the aorta and its major branches, mainly involving extra cranial branches of the carotid artery. We report a 72-year-old man presenting with weight loss, fever and malaise. Positron emission computed tomography (PET CT) showed an extensive inflammation of the aorta and its major branches. Temporal artery biopsy confirmed the presence of vasculitis with granulomas. Treatment with a high dose of steroids had an excellent clinical response...
November 2016: Revista Médica de Chile
Haner Direskeneli
Takayasu's arteritis (TAK) is a rare, chronic, large-vessel vasculitis (LVV) that predominantly affects aorta, its major branches and the pulmonary arteries. Recent controversial issues in the diagnosis, disease assessment and prognosis in TAK are discussed in this review. In recent years, conventional angiography, the standard method for the initial diagnosis, seems to have been replaced by the new imaging modalities, such as MRI and 18F-FDG-PET. Less invasive techniques (CT/MRI) are now suggested first, compared to conventional angiography, and MRI is preferable to CT with less contrast load/radiation...
March 27, 2017: Clinical and Experimental Rheumatology
Knut Kurt William Kampe, Roman Rotermund, Milena Tienken, Götz Thomalla, Marc Regier, Susanne Klutmann, Stefan Kluge
PURPOSE: (18)F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is a promising new tool for the identification of inflammatory, infectious, and neoplastic foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in patients treated on a neurological/neurosurgical ICU or stroke unit. METHODS: We performed a single-center, 10-year, retrospective evaluation of the value of FDG-PET/CT in critically ill adult patients with severe neurological disease...
2017: Frontiers in Neurology
Taryn Youngstein, Enrico Tombetti, Jaita Mukherjee, Tara D Barwick, Adil Al-Nahhas, Emyr Humphreys, Julian Nash, Jacqueline Andrews, Elena Incerti, Elisabetta Tombolini, Annalaura Salerno, Silvia Sartorelli, Giuseppe A Ramirez, Maurizio Papa, Maria Grazia Sabbadini, Luigi Gianolli, Francesco De Cobelli, Federico Fallanca, Elena Baldissera, Angelo A Manfredi, Maria Picchio, Justin C Mason
OBJECTIVES: This study investigated the incidence and clinical significance of arterial graft-associated uptake of fluorodeoxyglucose in large-vessel vasculitis (LVV). BACKGROUND: The role of (18)F-labeled fluorodeoxyglucose-positron emission tomography/computed tomography ([(18)F]FDG-PET/CT) in the management of LVV remains to be defined. Although [(18)F]FDG uptake at arterial graft sites raises concerns regarding active arteritis or infection, its clinical significance in LVV has never been formally studied...
January 11, 2017: JACC. Cardiovascular Imaging
Francesco Muratore, Nicolò Pipitone, Carlo Salvarani, Wolfgang A Schmidt
The increasing availability and improvement of imaging techniques are making a profound impact in the evaluation and management of patients with vasculitis, particularly for those with large vessel vasculitis, and will most likely play an ever more important role in the future. Deep, large vessels can be examined by CT or MRI, while ultrasound is the method of choice for the evaluation of superficial vessels (such as temporal, carotid, and axillary arteries). PET is very sensitive in detecting large vessel inflammation, but it does not delineate the vessel wall...
August 2016: Best Practice & Research. Clinical Rheumatology
Sergio Prieto-González, Georgina Espígol-Frigolé, Ana García-Martínez, Marco A Alba, Itziar Tavera-Bahillo, José Hernández-Rodríguez, Arturo Renú, Rosa Gilabert, Francisco Lomeña, Maria C Cid
Various imaging modalities, including color duplex ultrasonography, CT angiography, magnetic resonance angiography, and PET, are emerging as important aids to the diagnosis, staging, evaluation of disease activity and response to treatment in systemic vasculitis. Although large-vessel vasculitis is the main target of imaging, refinement and increasing accuracy of imaging modalities are also providing useful information in the evaluation of medium-vessel and small-vessel vasculitis.
November 2016: Rheumatic Diseases Clinics of North America
Hubert de Boysson, Eric Liozon, Marc Lambert, Jean-Jacques Parienti, Nicolas Artigues, Loïk Geffray, Jonathan Boutemy, Yann Ollivier, Gwénola Maigné, Kim Ly, Damien Huglo, Eric Hachulla, Pierre-Yves Hatron, Achille Aouba, Alain Manrique, Boris Bienvenu
Previous studies reported a 2- to 17-fold higher risk of aortic complications (dilation or dissection) in patients with giant-cell arteritis (GCA). We aimed to determine whether or not GCA patients with large-vessel involvement demonstrated by positron emission tomography with F-fluorodeoxyglucose combined with computed tomography (FDG-PET/CT) have a higher risk of aortic complications. We conducted a retrospective multicenter study between 1995 and 2014. Patients were included if they fulfilled at least 3 American College of Rheumatology criteria for GCA, or 2 criteria associated with extratemporal biopsy-proven giant-cell vasculitis; they underwent at least 1 FDG-PET/CT scan at diagnosis or during follow-up; and the morphology of the aorta was assessed by medical imaging at diagnosis...
June 2016: Medicine (Baltimore)
Darshan Patel, Karen Xie, Nadera J Sweiss, Yang Lu
A 65-year-old woman with history of sarcoidosis, hypertension, and peripheral vascular disease presented with lower extremity claudication and low left ventricular ejection fraction of 45% on echocardiogram. Further FDG PET/CT revealed hypermetabolic bilateral chest lymphadenopathy and pulmonary nodules in a butterfly-shaped distribution pattern, which was typically seen in patients with sarcoidosis. In addition, abnormal increased radiotracer uptake was present in pericardium, and along the walls of inferior vena cava, aorta, and pulmonary artery, which correlated with delayed enhancement on further cardiac MRI...
August 2016: Clinical Nuclear Medicine
Andreas Buck, Clemens Decristoforo
The EANM 2015 Annual Congress, held from October 10th to 14th in Hamburg, Germany, was outstanding in many respects. With 5550 participants, this was by far the largest European congress concerning nuclear medicine. More than 1750 scientific presentations were submitted, with more than 250 abstracts from young scientists, indicating that the future success of our discipline is fuelled by a high number of young individuals becoming involved in a multitude of scientific activities. Significant improvements have been made in molecular imaging of cancer, particularly in prostate cancer...
September 2016: European Journal of Nuclear Medicine and Molecular Imaging
Massimo Castellani, Manuela Vadrucci, Luigia Florimonte, Monica Caronni, Riccardo Benti, Paola Bonara
OBJECTIVE: Over the last decade, the contribution of (18)F-FDG (FDG) PET/CT imaging to the diagnosis of large vessel vasculitis has been widely investigated. The aim of this study was to evaluate a more extensive role for PET/CT in grading vascular inflammation in patients with different clinical stages of disease. METHODS: The images of 66 PET/CT studies of 34 patients, performed at diagnosis and/or during follow-up were reviewed. FDG uptake in different regions of aorta and in its major branches was visually (regional Score: rS) and semiquantitatively (regional SUVmean: rSUV) assessed...
July 2016: Annals of Nuclear Medicine
Giuseppe Germanò, Pierluigi Macchioni, Niccolò Possemato, Luigi Boiardi, Alberto Nicolini, Massimiliano Casali, Annibale Versari, Nicolò Pipitone, Carlo Salvarani
OBJECTIVE: To assess the findings of contrast-enhanced ultrasound (CEUS) of carotid arteries in patients with large vessel vasculitis (LVV) and to compare them with those observed using (18) F-fluorodeoxyglucose-positron emission tomography ((18) FDG-PET). METHODS: A total of 31 consecutive patients with LVV (14 with Takayasu arteritis, 17 with giant cell arteritis with large vessel involvement) underwent both PET/computed tomography and carotid artery color Doppler ultrasound (CDUS) for a total of 35 combined assessments...
January 2017: Arthritis Care & Research
Fotini Baziaka, Ilias Karaiskos, Lamprini Galani, Eleftheria Barmpouti, Stilianos Konstantinidis, George Kitas, Helen Giamarellou
Q fever is a zoonosis caused by the rickettsial organism Coxiella burnetii. Infection has an acute course, usually with a self-limited febrile illness and the possibility of the evaluation to a chronic course with endocardial involvement. The presence of autoantibodies and various autoimmune disorders have also been associated with C. burnetii infection. We report a case of acute Q fever in which the patient developed large vessel vasculitis. The FDG-PET/CT scan detected inflammation of the thoracic aortic wall, suggesting an unusual immunologic host response to acute Q fever infection...
2014: IDCases
A Mekinian, S Djelbani, F Viry, O Fain, M Soussan
The imaging is essential for the diagnosis of large vessels arteritis, in order to assess the persistent inflammation of arterial lesions, to evaluate the treatment response and search the vascular complications. In patients with giant cell arteritis (GCA), the aortitis could be suspected in 2 situations: in the presence of general constitutional symptoms or systematic screening of aortitis in patient with confirmed GCA. The frequency of aortitis varies according to the imaging method and could be detected in 40 % of patients with computed tomography and MRI, and approximately in 60 % with FDG-PET/CT...
April 2016: La Revue de Médecine Interne
Y H Lee, S J Choi, J D Ji, G G Song
OBJECTIVE: The purpose of this study was to evaluate the diagnostic performance of 18F-fluorodeoxyglucose positron-emission tomography (18F-FDG PET) or positron-emission tomography/computed tomography (PET/CT) for patients with large vessel vasculitis. METHODS: Based on a search in the PubMed, Embase, and Cochrane Library databases, a meta-analysis was performed on the diagnostic accuracy of 18F-FDG PET or PET/CT in patients with large vessel vasculitis. RESULTS: A total of eight studies involving 400 subjects (170 vasculitis patients and 230 controls) were selected for meta-analysis...
November 2016: Zeitschrift Für Rheumatologie
Joohae Kim, Myoung-Don Oh
Takayasu arteritis is a chronic vasculitis involving the large vessels. At diagnosis, ischemic symptom are usually present in the affected vessels. However, fever of unknown origin (FUO) is rare as an initial presentation and renders the condition difficult to diagnose. In this case report, we describe a patient who presented with a fever of unknown origin. A 68-year-old female was diagnosed with Takayasu arteritis after fluorodeoxyglucose (FDG) positron-emission tomography-computed tomography (PET-CT) was performed at the prepulseless stage...
September 2015: Infection & Chemotherapy
Menno D Stellingwerff, Elisabeth Brouwer, Karel-Jan D F Lensen, Abraham Rutgers, Suzanne Arends, Kornelis S M van der Geest, Andor W J M Glaudemans, Riemer H J A Slart
Giant cell arteritis (GCA) is the most frequent form of vasculitis in persons older than 50 years. Cranial and systemic large vessels can be involved. [¹⁸F] fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) is increasingly used to diagnose inflammation of the large arteries in GCA. Unfortunately, no consensus exists on the preferred scoring method. In the present study, we aim to define the optimal FDG PET/CT scoring method for GCA diagnosis using temporal artery biopsy and clinical diagnosis as the reference method...
September 2015: Medicine (Baltimore)
J Loricera, R Blanco, J L Hernández, I Martínez-Rodríguez, J M Carril, C Lavado, M Jiménez, C González-Vela, M Á González-Gay
The term vasculitis encompasses a heterogeneous group of diseases that share the presence of inflammatory infiltrates in the vascular wall. The diagnosis of large-vessel vasculitis is often a challenge because the presenting clinical features are nonspecific in many cases and they are often shared by different types of autoimmune and inflammatory diseases including other systemic vasculitides. Moreover, the pathogenesis of large-vessel vasculitis is not fully understood. Nevertheless, the advent of new imaging techniques has constituted a major breakthrough to establish an early diagnosis and a promising tool to monitor the follow-up of patients with largevessel vasculitis...
November 2015: Revista Española de Medicina Nuclear e Imagen Molecular
L Dellavedova, M Carletto, P Faggioli, A Sciascera, A Del Sole, A Mazzone, L S Maffioli
PURPOSE: The aim of this study was to analyse if the result of a baseline (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/CT scan, in large-vessel vasculitis (LVV) patients, is able to predict the course of the disease, not only in terms of presence/absence of final complications but also in terms of favourable/complicated progress (response to steroid therapy, time to steroid suspension, relapses, etc.). METHODS: A total of 46 consecutive patients, who underwent (18)F-FDG PET/CT between May 2010 and March 2013 for fever of unknown origin (FUO) or suspected vasculitis (before starting corticosteroid therapy), were enrolled...
February 2016: European Journal of Nuclear Medicine and Molecular Imaging
Magdy Soliman, Ronald Laxer, David Manson, Rae Yeung, Andrea S Doria
The term "systemic vasculitis" encompasses a diverse set of diseases linked by the presence of blood-vessel inflammation that are often associated with critical complications. These diseases are uncommon in childhood and are frequently subjected to a delayed diagnosis. Although the diagnosis and treatment may be similar for adult and childhood systemic vasculitides, the prevalence and classification vary according to the age group under investigation. For example, Kawasaki disease affects children while it is rarely encountered in adults...
July 2015: Pediatric Radiology
C Lavado-Pérez, I Martínez-Rodríguez, N Martínez-Amador, I Banzo, R Quirce, J Jiménez-Bonilla, M De Arcocha-Torres, Z Bravo-Ferrer, M Jiménez-Alonso, J L López-Defilló, R Blanco, M A González-Gay, J M Carril
PURPOSE: Polymyalgia rheumatica (PMR) may present together with large vessel vasculitis (LVV), and frequently requires a more intensive therapy. The aim of the study was to evaluate the impact of (18)F-FDG PET/CT in the diagnosis and management of LVV associated to PMR. MATERIAL AND METHODS: This prospective study included 40 consecutive patients (27 women/13 men, 68.10±10.27 years) with PMR and suspicion of associated LVV submitted for (18)F-FDG PET/CT. A PET/CT scan was obtained 180 min after (18)F-FDG intravenous injection...
September 2015: Revista Española de Medicina Nuclear e Imagen Molecular
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