The Utility of FDG PET/CT in IgG4-Related Disease with a Focus on Coronary Artery Involvement

Huang, Hian Liang; Fong, Warren; Peh, Wee Ming; Niraj, K; Lam, Winnie Wing Chuen

doi:10.1007/s13139-017-0494-5

Cited by 16 publications

(32 citation statements)

References 15 publications

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“…There is a growing role for the use of FDG-PET in the diagnostic evaluation and management of patients with systemic vasculitis [ 36 ]. FDG is fundamentally a glucose analogue and tends to accumulate in metabolic “hot spots” such as in inflammatory and autoimmune processes [ 37 ].…”

Section: Diagnosticsmentioning

confidence: 99%

“…Therefore, while FDG-PET may be useful in predicting potential vasculitc coronary artery involvement, specifically in higher-risk patients with cardiac vasculitis, it does not always discriminate between coronary atherosclerosis, which is more common than coronary artery vasculitis. The important limitations of FDG-PET include low availability, inability to differentiate between disease processes and false negatives in the setting of immunosuppressive therapy [ 36 – 39 ].…”

Section: Diagnosticsmentioning

confidence: 99%

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Coronary artery vasculitis: a review of current literature

Khanna

Garikapati

Goh

et al. 2021

BMC Cardiovasc Disord

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Cardiac vasculitis is recognized as a heterogeneous disease process with a wide spectrum of manifestations including pericarditis, myocarditis, valvular heart disease and less frequently, coronary artery vasculitis (CAV). CAV encompasses an emerging field of diseases which differ from conventional atherosclerotic disease and have a proclivity for the younger population groups. CAV portends multiple complications including the development of coronary artery aneurysms, coronary stenotic lesions, and thrombosis, all which may result in acute coronary syndromes. There are several aetiologies for CAV; with Kawasaki’s disease, Takayasu's arteritis, Polyarteritis Nodosa, and Giant-Cell Arteritis more frequently described clinically, and in literature. There is a growing role for multi-modality imaging in assisting the diagnostic process; including transthoracic echocardiography, cardiac magnetic resonance imaging, computed tomography coronary angiography, fluorodeoxyglucose-positron emission tomography and conventional coronary angiogram with intravascular ultrasound. Whilst the treatment paradigms fundamentally vary between different aetiologies, there are overlaps with pharmacological regimes in immunosuppressive agents and anti-platelet therapies. Interventional and surgical management are is a consideration in select populations groups, within a multi-disciplinary context. Further large-scale studies are required to better appropriately outline management protocols in this niche population.

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Section: Diagnosticsmentioning

confidence: 99%

Section: Diagnosticsmentioning

confidence: 99%

Coronary artery vasculitis: a review of current literature

Khanna

Garikapati

Goh

et al. 2021

BMC Cardiovasc Disord

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“…16 ). Coronary artery involvement in IgG4 related disease can be confirmed as increased FDG uptake in the coronary arteries [ 144 ] (Fig. 16 ).…”

Section: Extra-myocardial Findingmentioning

confidence: 99%

Series of myocardial FDG uptake requiring considerations of myocardial abnormalities in FDG-PET/CT

Minamimoto

2021

Jpn J Radiol

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Distinct from cardiac PET performed with preparation to control physiological FDG uptake in the myocardium, standard FDG-PET/CT performed with 4–6 h of fasting will show variation in myocardial FDG uptake. For this reason, important signs of myocardial and pericardial abnormality revealed by myocardial FDG uptake tend to be overlooked. However, recognition of possible underlying disease will support further patient management to avoid complications due to the disease. This review demonstrates the mechanism of FDG uptake in the myocardium, discusses the factors affecting uptake, and provides notable image findings that may suggest underlying disease.

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“…The disease is characterized by IgG4-expressing plasma cell organ infiltration, obliterative phlebitis, and storiform fibrosis. IgG4-RD may affect the vascular system of large-to-medium-sized vessel walls and coronary arteries [ 164 , 165 , 166 ]. IgG4-related aortitis and/or periaortitis are commonly located in the infrarenal abdominal aorta and iliac arteries [ 164 ].…”

Section: Fdg Beyond Cvdsmentioning

confidence: 99%

“…As many as 25/35 (71.4%) patients had more organ involvement detected by FDG-PET/CT than by conventional evaluations, including a physical examination, ultrasonography, and CT [ 169 ]. Another study by Huang et al with 12 patients assessed the utility of FDG-PET/CT in guiding biopsies for difficult sites, such as the coronary arteries, for the diagnoses of IgG4-RD, in addition to evaluating the disease response and recurrence [ 166 ]. Several studies reported an emerging role of FDG-PET/CT for assessing organ involvement, monitoring the therapeutic response, and guiding the interventional treatment of IgG4-RD [ 169 , 170 , 171 ].…”

Section: Fdg Beyond Cvdsmentioning

confidence: 99%

PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders

et al. 2021

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Positron emission tomography (PET) imaging with 18F-fluorodeoxyglucose (FDG) represents a method of detecting and characterizing arterial wall inflammation, with potential applications in the early assessment of vascular disorders such as atherosclerosis. By portraying early-stage molecular changes, FDG-PET findings have previously been shown to correlate with atherosclerosis progression. In addition, recent studies have suggested that microcalcification revealed by 18F-sodium fluoride (NaF) may be more sensitive at detecting atherogenic changes compared to FDG-PET. In this review, we summarize the roles of FDG and NaF in the assessment of atherosclerosis and discuss the role of global assessment in quantification of the vascular disease burden. Furthermore, we will review the emerging applications of FDG-PET in various vascular disorders, including pulmonary embolism, as well as inflammatory and infectious vascular diseases.

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The Utility of FDG PET/CT in IgG4-Related Disease with a Focus on Coronary Artery Involvement

Cited by 16 publications

References 15 publications

Coronary artery vasculitis: a review of current literature

Coronary artery vasculitis: a review of current literature

Series of myocardial FDG uptake requiring considerations of myocardial abnormalities in FDG-PET/CT

PET-Based Imaging with 18F-FDG and 18F-NaF to Assess Inflammation and Microcalcification in Atherosclerosis and Other Vascular and Thrombotic Disorders

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