Role of FDG-PET and PET/CT in the diagnosis and management of vasculitis

• Published in: European journal of radiology 2010-03, Vol.73 (3), p.504-509
• Main Authors: Zerizer, Imene, Tan, Kathryn, Khan, Sameer, Barwick, Tara, Marzola, Maria Cristina, Rubello, Domenico, Al-Nahhas, Adil
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Diagnosis; Diagnosis, Differential; FDG; Fluorodeoxyglucose F18; Humans; Medical sciences; PET; PET/CT; Positron-Emission Tomography - methods; Radiology; Radiopharmaceuticals; Response to treatment; Sarcoidosis. Granulomatous diseases of unproved etiology. Connective tissue diseases. Elastic tissue diseases. Vasculitis; Sensitivity and Specificity; Tomography, X-Ray Computed - methods; Vasculitis; Vasculitis - diagnostic imaging
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2010.01.021

Abstract Purpose to investigate the role of FDG-PET and PET/CT in the evaluation of vasculitis. Materials and methods a systematic revision of the papers published in PubMed/Medline until December 2009 was done. Results FDG-PET and PET/CT have been proven to be valuable in the diagnosis of large-vessel vasculitis, especially giant cells arteritis with sensitivity values ranging 77% to 92%, and specificity values ranging 89% to 100%. In particular, FDG-PET/CT has demonstrated the potential to non-invasively diagnose the onset of the vasculitis earlier than traditional anatomical imaging techniques, thus enabling prompt treatment. False positive results mainly occur in the differential diagnosis between vasculitis and atherosclerotic vessels in elderly patients. Another area where FDG-PET/CT is gaining wider acceptance is in monitoring response to therapy; it can reliably detect the earliest changes of disease improvement post-therapy, and persistent activity is an indicator of non-responders to therapy. A few data have been reported about medium/small vessel vasculitis. Discussion FDG-PET and PET/CT have proven utility: (a) in the initial diagnosis of patients suspected of having vasculitis particularly in those who present with non-specific symptoms; (b) in the identification of areas of increased FDG uptake in which a biopsy should be done for obtaining a diagnosis; (c) in evaluating the extent of the disease; (d) in assessing response to treatment.