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PET-CT and large vessel vasculitis

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 18F-FDG positron emission tomography (FDG-PET). METHODS: 31 consecutive patients with LVV (14 with Takayasu, 17 with giant cell arteritis with large vessel involvement) underwent both PET/CT and carotid artery colour Doppler ultrasonography (CDUS) for a total of 35 combined assessments...
April 5, 2016: 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...
December 25, 2015: 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
Asad Khan, Bhaskar Dasgupta
Much progress has been made in the use of imaging as a diagnostic tool in giant cell arteritis (GCA), which assists in the management of patients where the initial diagnosis is unclear. This includes patients with atypical cranial symptoms, or with predominantly systemic, constitutional or limb symptoms. Ultrasound and magnetic resonance imaging are capable of visualising both the cranial and extracranial large vessel circulation, with vessel wall thickening and stenotic lesions being visualised. Computed tomographic angiography is helpful in visualising the aorta for aneurysm complicating GCA but can also detect vessel wall thickening in established large vessel vasculitis...
August 2015: Current Rheumatology Reports
Alessandra Palmisano, Maria L Urban, Domenico Corradi, Rocco Cobelli, Federico Alberici, Federica Maritati, Annibale Versari, Nicolò Pipitone, Carlo Salvarani, Carlo Buzio, Augusto Vaglio
OBJECTIVE: Chronic periaortitis (CP) is a rare disease characterized by fibro-inflammatory tissue surrounding the abdominal aorta and the iliac arteries. Anecdotal reports have shown that CP may also involve other vascular districts, particularly the thoracic aorta. The aim of this study was to investigate the thoracic aorta and epiaortic artery involvement in CP. METHODS: Patients were eligible if they had undergone imaging studies assessing inflammatory involvement of the thoracic aorta and its major branches (e...
November 2015: Rheumatology
Michael J Kemna, Jan Bucerius, Marjolein Drent, Stefan Vöö, Martine Veenman, Pieter van Paassen, Jan Willem Cohen Tervaert, Marinus J P G van Kroonenburgh
PURPOSE: The objective of the study was to systematically assess aortic inflammation in patients with granulomatosis with polyangiitis (GPA) using (18)F-2-deoxy-2-[(18)F]fluoro-D-glucose (FDG) positron emission tomography (PET)/CT. METHODS: Aortic inflammation was studied in PET/CT scans obtained from 21 patients with GPA; 14 patients with sarcoidosis were included as disease controls, 7 patients with stage I or II head and neck carcinoma ascertained during routine clinical practice were used as healthy controls (HC) and 5 patients with large vessel vasculitis (LVV) were used as positive controls...
August 2015: European Journal of Nuclear Medicine and Molecular Imaging
S Vaidyanathan, C N Patel, A F Scarsbrook, F U Chowdhury
Integrated positron emission tomography/computed tomography (PET/CT) with the glucose analogue, 2-[(18)F]-fluoro-2-deoxy-d-glucose (FDG), is an evolving hybrid imaging technique in the evaluation of an important and diverse group of pathological conditions, which are characterised by infection and aseptic inflammation. With a rapidly expanding body of evidence, it is being increasingly recognised that, in addition to its established role in oncological imaging, FDG PET/CT also has clinical utility in suspected infection and inflammation...
July 2015: Clinical Radiology
Ingo Einspieler, Klaus Thürmel, Thomas Pyka, Matthias Eiber, Sabine Wolfram, Philipp Moog, Christian Reeps, Markus Essler
PURPOSE: The aim of this study was to evaluate the feasibility of hybrid [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI in patients with large vessel vasculitis (LVV) by comparing visual and quantitative parameters to that of PET/CT. Furthermore, the value of PET/MRI in disease activity and extent of LVV was assessed. METHODS: A total of 16 [(18)F]FDG PET/MRI and 12 [(18)F]-FDG PET/CT examinations were performed in 12 patients with LVV. MRI of the vessel wall by T1-weighted and T2-weighted sequences was used for anatomical localization of FDG uptake and identification of morphological changes associated with LVV...
June 2015: European Journal of Nuclear Medicine and Molecular Imaging
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