Advances in PET Imaging of Large Vessel Vasculitis: An Update and Future Trends

van der Geest, Kornelis S.M; Gheysens, Olivier; Gormsen, Lars C.; Glaudemans, Andor W.J.M.; Tsoumpas, Charalampos; Brouwer, Elisabeth; Nienhuis, Pieter H.; van Praagh, Gijs D.; Slart, Riemer H.J.A.

doi:10.1053/j.semnuclmed.2024.03.001

Seminars in Nuclear Medicine

2024

DOI: 10.1053/j.semnuclmed.2024.03.001

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Advances in PET Imaging of Large Vessel Vasculitis: An Update and Future Trends

Kornelis S.M van der Geest,

Olivier Gheysens,

Lars C. Gormsen

et al.

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Cited by 3 publications

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Letter from the Editors

Bouchelouche,

Sathekge

2024

Seminars in Nuclear Medicine

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Letter from the Editors

Bouchelouche,

Sathekge

2024

Seminars in Nuclear Medicine

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Imaging in vasculitis

Troum,

Pimienta,

Wells

2024

Current Opinion in Rheumatology

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Purpose of review Systemic vasculitides are characterized by inflammation of blood vessels. Their classification is based on the size of the blood vessels involved – large, medium, or small. Vasculitis early diagnosis and reliable monitoring are crucial to establish a treatment plan and prevent serious complications. Based on these considerations and depending on the location of the affected vessels, the importance of imaging modalities including ultrasonography (US), magnetic resonance Imaging (MRI), magnetic resonance angiography (MRA), computed tomography (CT), computed tomography angiography (CTA), and [18F]-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) has progressively increased. In addition to physical exam and laboratory data, these imaging tools offer complementary information about vascular changes occurring in vasculitis. This review summarizes the different imaging modalities being utilized to diagnose and monitor vasculitis. Recent findings The most recent update for the use of imaging in vasculitis is referenced in the 2023 European Alliance of Associations for Rheumatology (EULAR) recommendations and the American College of Rheumatology (ACR) guidelines in 2021. Recent advances in PET imaging in large vessel vasculitis include improved technological imaging acquisition and the use of novel radiotracers for cellular and immune targets. FDG-PET has now been demonstrated to have high sensitivity and specificity to detect temporal arteritis. Summary Imaging plays a significant role in the evaluation of vasculitis and continues to gain importance in the diagnosis and monitoring of disease activity. Differences exist between the ACR guidelines, which advocates for temporal artery biopsy, and the EULAR guidelines, which favors imaging modalities for the initial evaluation and diagnosis of large vessel vasculitis (LVV). Prerequisites for appropriate clinical management utilizing imaging in patients with vasculitis are the availability and access to skilled clinicians to interpret the images and the cost of these techniques not being prohibitive.

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Role and potential of 18F-fluorodeoxyglucose-positron emission tomography-computed tomography in large-vessel vasculitis: a comprehensive review

Collada-Carrasco,

Gómez-León,

Castillo-Morales

et al. 2024

Front. Med.

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Large-vessel vasculitis (LVV) is a group of diseases characterized by inflammation of the aorta and its main branches, which includes giant cell arteritis (GCA), polymyalgia rheumatica (PMR), and Takayasu’s arteritis (TAK). These conditions pose significant diagnostic and management challenges due to their diverse clinical presentations and potential for serious complications. 18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG-PET-CT) has emerged as a valuable imaging modality for the diagnosis and monitoring of LVV, offering insights into disease activity, extent, and response to treatment. 18F-FDG-PET-CT plays a crucial role in the diagnosis and management of LVV by allowing to visualize vessel involvement, assess disease activity, and guide treatment decisions. Studies have demonstrated the utility of 18F-FDG-PET-CT in distinguishing between LVV subtypes, evaluating disease distribution, and detecting extracranial involvement in patients with cranial GCA or PMR phenotypes. Additionally, 18F-FDG-PET-CT has shown promising utility in predicting clinical outcomes and assessing treatment response, based on the correlation between reductions in FDG uptake and improved disease control. Future research should focus on further refining PET-CT techniques, exploring their utility in monitoring treatment response, and investigating novel imaging modalities such as PET-MRI for enhanced diagnostic accuracy in LVV. Overall, 18F-FDG-PET-CT represents a valuable tool in the multidisciplinary management of LVV, facilitating timely diagnosis and personalized treatment strategies to improve patient outcomes.

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Advances in PET Imaging of Large Vessel Vasculitis: An Update and Future Trends

Cited by 3 publications

References 47 publications

Letter from the Editors

Letter from the Editors

Imaging in vasculitis

Role and potential of 18F-fluorodeoxyglucose-positron emission tomography-computed tomography in large-vessel vasculitis: a comprehensive review

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