Parameters related to a positive test result for FDG PET(/CT) for large vessel vasculitis: a multicenter retrospective study

Clin Rheumatol. 2012 May;31(5):861-71. doi: 10.1007/s10067-012-1945-0. Epub 2012 Feb 10.

Abstract

The purpose of this study was to identify clinical and laboratory parameters that may improve the effectiveness of the use of fluorodeoxyglucose positron emission tomography ((18)F-FDG PET)(/CT) for diagnosing large vessel vasculitis (LVV), and secondarily to assess the contribution of (18)F-FDG PET/CT in finding other diagnoses for patients without signs of LVV on the scan. A multicenter retrospective study of (18)F-FDG PET(/CT) scans performed between January 2000 and December 2009 for clinical suspicion of LVV was conducted. A total of 304 (18)F-FDG PET(/CT) scans were included, of which 62 (20%) were positive and 242 (80%) were negative for LVV. Univariate analysis showed that patients with a positive scan were older (65.9 ± 13.4 versus 58.6 ± 16.5 years, p = 0.002), were more frequently female (76% versus 55%, p = 0.002), more often had a history of temporal arteritis (10% versus 3%, p = 0.044), less frequently had artralgia (31% versus 67%, p = 0.000), and had higher thrombocyte counts (434 ± 161 versus 373 ± 168 × 10(9)/l, p = 0.049) and a higher erythrocyte sedimentation rate (ESR) (72.6 ± 31.0 versus 51.4 ± 30.5 mm/h, p = 0.001) than patients with a negative scan. In the multivariate analysis, only artralgia (OR 0.091; 95% CI 0.023-0.366) and ESR (OR 1.024; 95% CI 1.002-1.046) remained statistically significant predictors. The presence of artralgia is a statistically significant negative predictor and an elevated ESR a statistically significant positive predictor of LVV showing up on (18)F-FDG PET(/CT). A reliable prediction of the outcome of the scan, based on these two parameters, is not possible however. (18)F-FDG PET(/CT) allows early diagnosis of LVV and may discover occult inflammatory or neoplastic disorders.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Early Diagnosis
  • Female
  • Fluorodeoxyglucose F18*
  • Giant Cell Arteritis / blood
  • Giant Cell Arteritis / complications
  • Giant Cell Arteritis / diagnosis*
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / blood
  • Neoplasms / diagnosis
  • Positron-Emission Tomography / methods*
  • Radiopharmaceuticals*
  • Retrospective Studies

Substances

  • Radiopharmaceuticals
  • Fluorodeoxyglucose F18