18-FDG PET for large vessel vasculitis diagnosis and follow-up

Angelotti, Francesca; Capecchi, Riccardo; Giorgetti, Alejandro; Erba, Paola Anna; Genovesi, Dario; Emdin, M.; Barison, Andrea; Manca, Maria Laura; Migliorini, Paola; Tavoni, Antonio

doi:10.55563/clinexprheumatol/3cneda

Cited by 7 publications

(4 citation statements)

References 30 publications

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“…This is not unusual as it has been reported previously that disease activity shown by imaging may differ from clinical assessment ( 35 , 36 ). FDG-PET is a powerful tool for the diagnosis of GCA ( 37 ), but there are no consistent data regarding its relevance for the assessment of disease progression and prognosis. In our study, FDG-PET results did not correlate well with the clinical course, at least in the first months of TCZ treatment.…”

Section: Discussionmentioning

confidence: 99%

Giant cell arteritis with vertebral artery involvement—baseline characteristics and follow-up of a monocentric patient cohort

Prünte,

Naumann,

Christ

et al. 2023

Front. Neurol.

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Vertebral artery (VA) involvement in giant cell arteritis (GCA) has rarely been reported. We aimed to evaluate the prevalence, patients’ characteristics, and immunotherapies used in patients with GCA and VA involvement at diagnosis and 1 year follow-up, retrospectively including patients being diagnosed between January 2011 and March 2021 in our department. Clinical features, laboratory data, VA imaging, immunotherapy, and 1 year follow-up data were analyzed. Baseline characteristics were compared to GCA patients without VA involvement. Among all 77 cases with GCA, 29 patients (37.7%) had VA involvement, as diagnosed by imaging and/or clinical signs and symptoms. Gender distribution and erythrocyte sedimentation rate (ESR) were significantly different in the groups with and without VA involvement, with more women being affected (38/48 patients, 79.2%) and a significantly higher median ESR in patients without VA involvement (62 vs. 46 mm/h; p = 0.012). MRI and/or CT showed vertebrobasilar stroke at GCA diagnosis in 11 cases. 67/77 patients (87.0%) received high-dose intravenous glucocorticosteroids (GCs) at diagnosis, followed by oral tapering. Six patients were treated with methotrexate (MTX), one with rituximab, and five with tocilizumab (TCZ). 2/5 TCZ patients achieved clinical remission after 1 year, vertebrobasilar stroke within the first year occurred in 2/5 patients. Diagnosis of VA involvement might be underrecognized in GCA patients. VA imaging should be performed in elderly patients with vertebrobasilar stroke presenting with GCA symptoms, not to miss GCA as the etiology of stroke. Efficacy of immunotherapies in GCA with VA affection and long-term outcomes need to be investigated further.

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Section: Discussionmentioning

confidence: 99%

Giant cell arteritis with vertebral artery involvement—baseline characteristics and follow-up of a monocentric patient cohort

Prünte,

Naumann,

Christ

et al. 2023

Front. Neurol.

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“…In some cases of vasculitis, the clinical-serological approach can be insensitive during both initial evaluation and long-term monitoring, making 18-FDG PET a valuable diagnostic tool [ 16 ]. One of the key advantages of PET scans is their ability to detect vasculitis as well as other serious pathologies, such as infections or tumors, particularly in elderly patients with constitutional symptoms who do not exhibit specific clinical features of vasculitis [ 17 ].…”

Section: Discussionmentioning

confidence: 99%

A Rare Case of Single-Organ Vasculitis of the Hepatic Artery in a Female Patient: Diagnosis and Management Challenges

Quiceno,

Betancur,

Solano

et al. 2024

Cureus

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This case report describes a rare occurrence of isolated vasculitis of the hepatic artery in a female patient. The patient presented with abdominal pain, fever, and weight loss, and a diagnosis was made through a combination of imaging studies and serological evaluation of systemic vasculitis. The management of this case was challenging because of the involvement of the hepatic artery without any other clinical manifestations of the systemic disease, apart from the presence of rheumatoid factor and anti-citrullinated cyclic peptide. The authors highlight the importance of considering vasculitis as a potential diagnosis in patients with unexplained abdominal pain and fever and the need for a multidisciplinary approach to the management of these patients. This case also emphasizes the potential complications of vasculitis, including aneurysm formation, and the need for close monitoring and follow-up of these patients.

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“…We present a case of GCA in a 67-year-old female diagnosed with an FDG-PET/CT exhibiting increasing uptake in the thoracic aorta. The role of FDG-PET/CT in the diagnosis of large vessel vasculitis has been investigated through multiple studies with the objective of minimizing invasiveness as well as timely intervention in the setting of high clinical suspicion [4][5][6][7][8][9][10]. The purpose of this case is to highlight the value of FDG-PET/CT in diagnosing GCA and its utility, particularly in the context of negative TAB.…”

Section: Introductionmentioning

confidence: 99%

Positron Emission Tomography (PET) Scan as a Diagnostic Tool for Giant Cell Arteritis

Ramachandran¹,

Antala²,

Pudasainee³

et al. 2023

Cureus

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Giant cell arteritis (GCA) is an inflammatory vasculitis that typically affects the elderly, preferentially involving large and medium-sized arteries and can potentially cause irreversible loss of vision. Early diagnosis and treatment are necessary to prevent this dreaded complication. Temporal artery biopsy has been the gold standard test in diagnosing GCA, however, false negative results due to presence of skip lesions, restricted inflammation, and early initiation of steroids have limited its diagnostic significance. We report a case of a 67-year-old female with headache, blurry vision, posterior scalp tenderness, feeble left temporal artery pulse on a physical exam with normal inflammatory markers. Temporal artery biopsy showed disruption and reduplication of internal elastic lamina without any evidence of giant cells or inflammatory cells. Owing to high clinical suspicion, fluorodeoxyglucose (FDG)-positron emission tomography (PET)/computed tomography (CT) was further done which revealed mildly increased uptake in the thoracic aorta, consistent with a diagnosis of large vessel vasculitis.

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18-FDG PET for large vessel vasculitis diagnosis and follow-up

Cited by 7 publications

References 30 publications

Giant cell arteritis with vertebral artery involvement—baseline characteristics and follow-up of a monocentric patient cohort

Giant cell arteritis with vertebral artery involvement—baseline characteristics and follow-up of a monocentric patient cohort

A Rare Case of Single-Organ Vasculitis of the Hepatic Artery in a Female Patient: Diagnosis and Management Challenges

Positron Emission Tomography (PET) Scan as a Diagnostic Tool for Giant Cell Arteritis

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