Patients with Takayasu's arteritis having persistent acute-phase response usually have an increased major vessel uptake by 18F-FDG-PET/CT

Abstract

We observed increased 18F-FDG uptake in the majority of TAK patients with an increased APR, but clinically silent disease. 18F-FDG-PET/CT showed the presence and localization of active inflammation in the aorta and its branches. Although specificity for observed lesions is not clear, 18F-FDG-PET/CT imaging may influence physician's assessment of clinical activity and treatment choices in TAK.

FDG Uptake by Prosthetic Arterial Grafts in Large Vessel Vasculitis Is Not Specific for Active Disease

“…Determining whether low grade 18 F-FDG-uptake represents active arteritis requiring treatment escalation, noninflammatory remodelling, or local glucose analogue uptake without major clinical relevance is challenging. Clinical studies offer contrasting conclusions concerning the relationship between 18 F-FDG uptake and disease activity biomarkers [9][10][11][12]. Adding to this complexity, our study of 18 F-FDG-PET/CT scans performed on 26 patients more than six months after arterial graft surgery demonstrates that 18 F-FDG avidity of the prosthetic graft exceeds that of the native aorta.…”

“…Second, whilst in active TA the sensitivity and specificity of 18 F-FDG-PET/CT may be high [3], opinion is divided concerning its sensitivity for detecting partially-treated or relapsing disease [8]. Relatively poor correlation between 18 F-FDG uptake and disease activity markers is reported [9], while other studies suggest a closer relationship [10][11][12]. Although the intense linear arterial wall 18 F-FDG uptake seen in active LVV may be reduced by immunosuppression [13], it is not uncommon to find low-grade uptake in those with clinically inactive disease and normal acute phase reactants [9].…”

Radiology and biomarkers in assessing disease activity in Takayasu arteritis

“…Qualitative assessment has been most commonly used, with visual comparison of arterial uptake and constitutive uptake in normal tissue, often the liver, using a four‐point scale . A close relationship between 18 F‐FDG uptake and disease activity markers has been observed in some studies . However, there are still some questions regarding its sensitivity and specificity for the detection of low‐grade relapsing or partially treated arteritis.…”

Fluorine-18-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography in Diagnosis and Assessment of Takayasu Arteritis and Ulcerative Colitis

“…To the patient with both TA and UC, we used PET/CT for assessing not only the disease activity but also treatment response, which is the unique point of our report. Other cases are summarized at the Table 1 including diagnostic, treatment and follow up tool [4][5][6][7][8][9][10][12][13][14][15]. The disease activity of TA was evaluated from 18 F-FDG PET/CT, it showed good performance in the assessment of vessel inflammation.…”

“…Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) positron emission tomography (PET)/computed tomography (CT) has been used as a diagnostic and follow-up tool for TA [3][4][5]. Since it is an imaging modality that reflects metabolic status, it assesses TA activity in terms of vascular metabolic uptake.…”