Relapsing Polychondritis on PET/CT

Deng, Hongxin; Chen, Ping; Wang, Limin; Li, Xiaxia; Yi, Jiaojiao

doi:10.1097/rlu.0b013e31823eae56

Cited by 21 publications

(11 citation statements)

References 9 publications

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“…These findings suggest that PET/CT is a promising radiological tool for monitoring the treatment response and disease progress. However, because there is no consensus about the duration of corticosteroid treatment, there is no consensus regarding the use of PET/CT to optimise corticosteroid strategies, although some reports have pointed to its potential value [9][10][11][12][13][14][15]. The time interval for PET/CT scans after corticosteroid therapy remains unclear, as it has been reported to range from 1 month to 13 months [9-11, 13, 18].…”

Section: Discussionmentioning

confidence: 99%

“…Patient Nos. 1 and 3 have previously been described in separate case reports, [12,20] and data on 6 patients (Nos. 1-6) have been retrospectively reviewed in a previous study [17].…”

Section: Study Design and Settingmentioning

confidence: 97%

“…In 2007, Nishiyama et al [8] first described a case of RP diagnosed using fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT). Since then, a series of case reports have demonstrated that PET/ CT is capable of determining the distribution of all lesions and facilitating their early recognition, locating biopsy sites, and evaluating disease activity and the therapeutic response to treatment [9][10][11][12][13][14][15][16]. However, these were mostly single case reports, and there has been no comprehensive study focusing on the application of PET/CT in RP.…”

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: A re-evaluation of 18F-FDG PET/CT for diagnosing relapsing polychondritis and monitoring the therapeutic response to treatment

Wang¹,

Li²,

Chen³

et al. 2018

Oncotarget

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Background: Relapsing polychondritis (RP) is a rare degenerative disease and its diagnosis is often delayed and difficult. Although the use of 18 F-fluorodeoxyglucose positron emission tomography/computed tomography (18 F-FDG PET/CT) for diagnosing RP has been reported previously, its true diagnostic value is uncertain due to the limited number of published case reports. Moreover, its value for biopsy guidance and therapeutic response monitoring remain controversial. Materials and Methods: Data on 30 patients with a clinical diagnosis of RP who underwent PET/CT scans were retrospectively reviewed. Follow-up scans were performed in 10 patients, and visual scores (VS) and maximal standard uptake (SUV max) values were analysed. Results: With the initial scan, 83.3% of patients showed lesions in more than one cartilage. Mean VS and SUV max values in the cartilages were 2.92 ± 0.38 and 4.06 ± 0.18, respectively. In 18 patients with no history of corticosteroid treatment, more cartilages were affected than in patients who previously received corticosteroids (3.89 ± 0.29 vs 2.75 ± 0.63, respectively; p = 0.07). Positive rates for PET/CT-guided biopsy in nasal, auricular and tracheal/bronchial cartilages were 100%, 88.9% and 10.5%, respectively. In comparison, the positive rate for non-PET/CT-guided biopsy of auricular cartilage was 92.3%. Compared with the initial scan, the second scan had significantly lower mean VS (1.41 ± 0.20 vs 2.92 ± 0.38, respectively; p < 0.0001) and SUVmax values (2.76 ± 0.14 vs 4.06 ± 0.18, respectively; p < 0.001). Conclusions: FDG uptake in multiple cartilages suggests a diagnosis of RP, but repeated administration of corticosteroids may undermine the diagnostic value of 18 F-FDG PET/CT. Further investigation of its use in locating biopsy sites and in monitoring the response to treatment is required.

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Section: Discussionmentioning

confidence: 99%

“…Patient Nos. 1 and 3 have previously been described in separate case reports, [12,20] and data on 6 patients (Nos. 1-6) have been retrospectively reviewed in a previous study [17].…”

Section: Study Design and Settingmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

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WITHDRAWN: A re-evaluation of 18F-FDG PET/CT for diagnosing relapsing polychondritis and monitoring the therapeutic response to treatment

Wang¹,

Li²,

Chen³

et al. 2018

Oncotarget

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“…Patient nos. 1 and 3 were previously reported in separate case reports [13, 23], and information on 6 patients (nos. 1–6) was retrospectively reviewed [20].…”

Section: Methodsmentioning

confidence: 99%

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

Zeng

Chen

et al. 2019

Arthritis Res Ther

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Background18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) is a promising tool for diagnosing relapsing polychondritis (RP). However, its usefulness in assessing RP with airway involvement is unknown.ObjectiveThis study aimed to further evaluate and confirm the potency of 18F-FDG PET/CT in diagnosing RP with airway involvement and monitoring response to steroid-based therapy.MethodsA total of 30 patients from a dedicated respiratory centre, diagnosed with RP in accordance with McAdam, Damiani or Levine criteria, were included in this study. All patients underwent baseline 18F-FDG PET/CT, and 10 patients underwent second scans after 2.5–15 months of steroid-based therapy. Visual scores (VS) and maximal standard uptake values (SUVmax) were analysed.ResultsIn the initial scan, 83.3% (25/30) of patients were found to have FDG uptake in more than one cartilage. The median VS and SUVmax in the cartilages were 3 (range, 1–3) and 3.8 (range, 1.9–17.9), respectively. Positive rates for PET/CT-guided biopsy in nasal, auricular, and tracheal/bronchial cartilages were 100% (5/5), 88.9% (8/9), and 10.5% (2/19), respectively, but the positive biopsy rate in the auricular cartilage was 92.3% (12/13) even without PET/CT assessment. Based on biopsy-proven sites, the sensitivity of PET/CT was 55.6%, and the specificity was 5.3%. Compared with the baseline scan, the second scan showed much lower median VS (2 vs 3, respectively; p < 0.0001) and SUVmax (2.9 vs 3.8, respectively; p < 0.001). Of 10 patients who underwent second PET/CT, 8 had complete therapeutic response, while 2 had partial response.Conclusion18F-FDG PET/CT assists in identifying multiple cartilage involvement in RP, but it seems neither a sensitive nor specific modality in diagnosing RP with airway involvement. Moreover, PET/CT has limited utility in locating biopsy sites and monitoring therapeutic response to corticosteroids.

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“…(A) Nodular irregularities on the right posterolateral and anterior walls beginning from the middle of trachea, (b) soft endobronchial lesions with a tendency to bleed, obliterating the apertures of right main bronchus (70%) and left main bronchus (80%).A btracheal cartilage thickening accompanied by dense calcification, peripheral bronchial narrowing, and bronchiectasis can also occur. PET/CT scanning is useful for demonstrating multisystemic cartilage anomalies and for diagnosing RP(7).Generally, the diagnostic criteriadescribed by McAdam et al are followed in order to diagnose RP (3). These are: 1-Relapsing chondritis in both auriculae; 2-Nonerosive inflammatory arthritis;3-Chondritis in nasal cartilage; 4-Eye inflammation including conjunctivitis, keratitis, scleritis, episcleritis and/or uveitis; 5-Chondritis in the upper respiratory tract involving laryngeal and/or tracheal cartilage; 6-Cochlear or vestibular dysfunction.…”

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confidence: 99%

A case of relapsing polychondritis mimicking lung cancer

Canbay¹,

Yılmaz²,

Öztürk³

et al. 2017

Tuberk Toraks

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Relapsing polychondritis (RP) is a rare autoimmune disease, characterized by episodic inflammatory attacks on cartilaginous tissue. Elastic cartilage of the ears and nose, hyaline cartilage of the peripheral joints, vertebral fibrocartilage, tracheobronchial cartilage, and tissues rich in proteoglycan such as those in the eyes, heart, blood vessels, and inner ear are more likely to be affected. A 35-year-old male presented with complaints of hoarseness, tinnitus and dyspnea for 19 years, with a history of several diagnostic and therapeutic interventions for laryngeal and respiratory tract. He was diagnosed to have inflammation of the tracheobronchial cartilage, cardiac valvulopathy and conductive hearing loss after intensive diagnostic studies. He responded well to low-dose steroids in combination with methotrexate. RP is a diagnostically challenging condition and may cause significant morbidities during diagnosis. RP should be considered in differential diagnosis of airway obstruction as a rare condition.

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Relapsing Polychondritis on PET/CT

Cited by 21 publications

References 9 publications

WITHDRAWN: A re-evaluation of 18F-FDG PET/CT for diagnosing relapsing polychondritis and monitoring the therapeutic response to treatment

WITHDRAWN: A re-evaluation of 18F-FDG PET/CT for diagnosing relapsing polychondritis and monitoring the therapeutic response to treatment

Is 18F-FDG PET/CT useful for diagnosing relapsing polychondritis with airway involvement and monitoring response to steroid-based therapy?

A case of relapsing polychondritis mimicking lung cancer

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