Towards an optimal semiquantitative approach in giant cell arteritis: an 18F-FDG PET/CT case-control study
Towards an optimal semiquantitative approach in giant cell arteritis: an 18F-FDG PET/CT case-control study
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DOI：
10.1007/s00259-013-2545-1
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发表时间：
2014-01-01
影响因子：
9.1
通讯作者：
Agostini, Denis
中科院分区：
文献类型：
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作者：
Besson, Florent L.;de Boysson, Hubert;Agostini, Denis
巨细胞动脉炎（GCA）是西方国家最常见的血管炎形式。 F-18-FDG PET已被证明是诊断颅外GCA的有价值的工具，但由于缺乏标准化的F-18-FDG PET标准，研究结果不一致。在这项研究中，我们使用对照设计比较了不同的半定量方法，以确定最有效的方法。对所有在我们的 PET 单位接受过 F-18-FDG PET/CT 扫描的活检证实的 GCA 患者进行了审查，并根据年龄和性别与对照组进行匹配。对 GCA 患者和匹配对照之间不同的半定量动脉（胸主动脉升主动脉和降主动脉和主动脉弓）与背景（肝、肺和静脉血池）SUV 比率进行盲法比较。我们纳入了 11 名活检证实的 GCA 病例患者和 11 名匹配对照。各组之间在体重、注射放射性、血糖水平或 CRP 方面没有差异。当应用于主动脉弓和胸降主动脉时，动脉与静脉血池比率比其他方法更好地区分两组（p < 0.015）。特别是，当应用于主动脉弓时，最高主动脉与最高血池 SUVmax 比率使用截止值 1.53 提供最佳诊断性能（敏感性 81.8%，特异性 91%，AUC 0.87；p < 0.0001）。在所有测试的 F-18-FDG PET/CT 方法中，主动脉与血池 SUVmax 比率优于肝脏和肺比率。我们建议使用该比率来评估 GCA 患者的主动脉炎症。
Giant cell arteritis (GCA) is the most common form of vasculitis in western countries. F-18-FDG PET has been shown to be a valuable tool for the diagnosis of extracranial GCA, but results of studies are inconsistent due to a lack of standardized F-18-FDG PET criteria. In this study, we compared different semiquantitative approaches using a controlled design to define the most efficient method.All patients with biopsy-proven GCA who had undergone an F-18-FDG PET/CT scan in our PET unit were reviewed and matched with a control group based on age and sex. Different semiquantitative arterial (ascending and descending thoracic aorta and aortic arch) to background (liver, lung and venous blood pool) SUV ratios were blindly compared between GCA patients and matched controls.We included 11 patients with biopsy-proven GCA cases and 11 matched controls. There were no differences between the groups with regard to body weight, injected radioactivity, blood glucose level or CRP. The arterial to venous blood pool ratios discriminated the two groups better than other methods when applied to the aortic arch and the descending thoracic aorta (p < 0.015). In particular, the highest aortic to highest blood pool SUVmax ratio, when applied to the aortic arch, provided optimal diagnostic performance (sensitivity 81.8 %, specificity 91 %, AUC 0.87; p < 0.0001) using a cut-off value of 1.53.Among all tested F-18-FDG PET/CT methods, the aortic to blood pool SUVmax ratio outperformed the liver and lung ratios. We suggest the use of this ratio for the assessment of aortic inflammation in GCA patients.