The assessment of biologic treatment in patients with rheumatoid arthritis using FDG-PET/CT

• Published in: Rheumatology (Oxford, England) England), 2012-08, Vol.51 (8), p.1484-1491
• Main Authors: OKAMURA, Koichi, YONEMOTO, Yukio, ARISAKA, Yukiko, TAKEUCHI, Kimihiko, KOBAYASHI, Tsutomu, ORIUCHI, Noboru, TSUSHIMA, Yoshito, TAKAGISHI, Kenji
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antibodies, Monoclonal - administration & dosage; Antirheumatic Agents - administration & dosage; Arthritis, Rheumatoid - diagnostic imaging; Arthritis, Rheumatoid - drug therapy; Biological and medical sciences; Diseases of the osteoarticular system; Etanercept; Female; Fluorodeoxyglucose F18; Follow-Up Studies; Humans; Immunoglobulin G - administration & dosage; Inflammatory joint diseases; Infliximab; Male; Medical sciences; Middle Aged; Multimodal Imaging - methods; Positron-Emission Tomography; Radiopharmaceuticals; Receptors, Tumor Necrosis Factor - administration & dosage; Severity of Illness Index; Tomography, X-Ray Computed; Treatment Outcome; Tumor Necrosis Factor-alpha - antagonists & inhibitors; Young Adult
• ISSN: 1462-0324; 1462-0332
• DOI: 10.1093/rheumatology/kes064

To evaluate whether there is a correlation between the differences in joint uptake of 2-[18F]-fluoro-2-deoxy-d-glucose ((18)F-FDG) and the improvement of clinical findings in RA patients undergoing anti-TNF therapies. Twenty-two patients who received anti-TNF therapies, including infliximab for 16 patients and etanercept for 6 patients, were assessed. PET with (18)F-FDG studies and clinical assessments were performed at baseline and 6 months after the initiation of therapy. The maximal standardized uptake value (SUV(max)) was used as a representative value for the assessment of the FDG uptake in the bilateral shoulder, elbow, wrist, hip, knee and ankle joints. Spearman's rank correlation test was applied to assess the correlation between the SUV and the clinical parameters. The ΔSUV (12 joints), the difference in the SUV(max) of the affected 12 joints before and after treatment, was positively correlated with the ΔDAS28 (r = 0.609, P = 0.003), ΔDAS28-CRP (r = 0.656, P = 0.001) and Δtender joint count (TJC) (r = 0.609, P = 0.003). There were also significantly positive correlations between ΔSUV (8 joints); the difference in the SUV(max) of the bilateral shoulder, elbow, wrist and knee joints before and after treatment and the ΔDAS28 (r = 0.642, P = 0.001), ΔDAS28-CRP (r = 0.712, P