Performance of the PET vascular activity score (PETVAS) for qualitative and quantitative assessment of inflammatory activity in Takayasu’s arteritis patients

• Published in: European journal of nuclear medicine and molecular imaging 2020-12, Vol.47 (13), p.3107-3117
• Main Authors: Kang, Fei, Han, Qing, Zhou, Xiang, Zheng, Zhaohui, Wang, Shengjun, Ma, Wenhui, Zhang, Kui, Quan, Zhiyong, Yang, Weidong, Wang, Jing, Zhu, Ping
• Format: Article
• Language: English
• Subjects: Arteritis; Biomarkers; Blood Sedimentation; C-reactive protein; Cardiology; Computed tomography; Correlation coefficients; Erythrocyte sedimentation rate; Erythrocytes; Fluorodeoxyglucose F18; Humans; Imaging; Infection and inflammation; Inflammation; Medicine; Medicine & Public Health; Nuclear Medicine; Oncology; Original Article; Orthopedics; Pentraxins; Positron emission; Positron Emission Tomography Computed Tomography; Qualitative analysis; Radiology; Remission; Takayasu Arteritis - diagnostic imaging; Tomography; Vein & artery diseases
• ISSN: 1619-7070; 1619-7089
• DOI: 10.1007/s00259-020-04871-2

Purpose To assess the performance of PET vascular activity score (PETVAS) in comparison with SUVmax, inflammatory biomarkers and ITAS-2010 score in a cohort of TAK patients. Methods Sixty-four PET/CT scans acquired from 54 TAK patients were analyzed. The inflammatory activity was qualitatively determined by physician’s global assessment and quantitatively determined by ITAS-2010 score. SUVmax and PETVAS were acquired by consensus review. Levels of the inflammatory biomarkers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and pentraxin-3 (PTX-3) were measured. Performance of the qualitative diagnoses and the quantitative correlation were, respectively, compared by receiver operating characteristic (ROC) curve and Spearman correlation coefficient. Results The biomarkers (CRP, ESR, PTX-3), PET uptake values (SUVmax, PETVAS), and ITAS-2010 scores were all significantly higher in active patients than in non-active ones. The area under the ROC curve and Youden Index of PETVAS and PTX-3 were higher than those of SUVmax, CRP, ESR, and ITAS-2010. PETVAS and PTX-3 resulted in a higher Spearman correlation coefficient with ITAS-2010 than other criteria, either among all patients or within the active group. Alteration trends of PETVAS and PTX-3 during follow-up showed a tighter correlation with clinical progression/remission assessment than other criteria. Conclusions In TAK evaluation, PETVAS is superior for qualitative and quantitative assessment, compared with the regional SUVmax. Compared to CRP and ESR, inflammatory biomarker PTX-3 shows better qualitative performance and a higher correlation with PETVAS and ITAS-2010. These findings indicate that the use of PETVAS and PTX-3, instead of SUVmax and CRP/ESR, has potential advantages in the clinical evaluation of TAK.