[18F] Florbetapir positron emission tomography: identification of muscle amyloid in inclusion body myositis and differentiation from polymyositis
[18F] Florbetapir positron emission tomography: identification of muscle amyloid in inclusion body myositis and differentiation from polymyositis
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DOI：
10.1136/annrheumdis-2018-214644
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发表时间：
2019-05-01
影响因子：
27.4
通讯作者：
Chinoy, Hector
中科院分区：
文献类型：
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作者：
Lilleker, James B.;Hodgson, Richard;Chinoy, Hector
目的利用现有的工具，确诊包涵体肌炎（IBM）可能是困难的。许多患者最初被误诊为多发性肌炎（PM）。在这项观察性研究在英国成人神经肌肉中心，我们调查了淀粉样蛋白正电子发射断层扫描是否可以区分IBM和PM。方法10例IBM和PM 6例进行了临床审查，[18 F] florbetapir正电子发射断层扫描和MRI的骨骼肌肉组织。评价了骨骼肌感兴趣区域中[18 F] florbetapir标准化摄取值比值的差异。[18F] florbetapir标准化摄取值比值与疾病严重程度指标之间的关系结果对于所有评估区域，与PM相比，IBM患者的[18 F] florbetapir标准化摄取值比率显著更高（总-[18 F] florbetapir标准化摄取值比值1.45（1.28 - 2.05）vs 1.01（0.80 - 1.22），p=0.005）。总[18 F] florbetapir标准化摄取值比值>= 1.28，敏感性和特异性为IBM是80%和100%，respectively.Conclusions [18 F] florbetapir淀粉样蛋白正电子发射断层扫描区分IBM从PM。成功的开发可以促进准确的诊断，纳入临床试验，并有助于避免不必要的暴露于潜在的有害治疗。
Objectives With the tools available currently, confirming the diagnosis of inclusion body myositis (IBM) can be difficult. Many patients are initially misdiagnosed with polymyositis (PM). In this observational study at a UK adult neuromuscular centre, we investigated whether amyloid positron emission tomography could differentiate between IBM and PM.Methods Ten patients with IBM and six with PM underwent clinical review, [18F] florbetapir positron emission tomography and MRI of skeletal musculature. Differences in [18F] florbetapir standardised uptake value ratios in skeletal muscle regions of interest were evaluated. Relationships between [18F] florbetapir standardised uptake value ratios and measures of disease severity (clinical and by MRI of skeletal muscle) were assessed.Results [18F] florbetapir standardised uptake value ratios were significantly higher in those with IBM compared with PM for all assessed regions (total-[18F] florbetapir standardised uptake value ratio 1.45 (1.28 to 2.05) vs 1.01 (0.80 to 1.22), p=0.005). For total-[18F] florbetapir standardised uptake value ratios >= 1.28, sensitivity and specificity for IBM was 80% and 100%, respectively.Conclusions [18F] florbetapir amyloid positron emission tomography differentiates IBM from PM. Successful development could facilitate accurate diagnosis, inclusion in clinical trials and help avoid unnecessary exposure to potentially harmful treatments.