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Clinical value of whole-body PET/CT in patients with active rheumatic diseases.

Yamashita H, Kubota K, Mimori A - Arthritis Res. Ther. (2014)

Bottom Line: Positron emission tomography (PET) provides highly sensitive, quantitative imaging at a molecular level, revealing the important pathophysiological processes underlying inflammation.This review provides an overview of the current utility of 18 F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in patients with active rheumatic diseases such as rheumatoid arthritis, spondyloarthritis, polymyalgia rheumatica, adult-onset Still's disease, relapsing polychondritis, immunoglobulin G4-related disease, large-vessel vasculitis, Wegener's granulomatosis, polymyositis, and dermatomyositis.We also discuss the role of FDG-PET/CT in the diagnosis and monitoring of these diseases.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatic Diseases, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo 162-8655, Japan. hiroyuki_yjp2005@yahoo.co.jp

ABSTRACT
Advanced imaging techniques may enable early diagnosis and monitoring of therapy in various rheumatic diseases. To prevent irreversible tissue damage, inflammatory rheumatic disease must be diagnosed and treated in pre-clinical stages, requiring highly sensitive detection techniques. Positron emission tomography (PET) provides highly sensitive, quantitative imaging at a molecular level, revealing the important pathophysiological processes underlying inflammation. This review provides an overview of the current utility of 18 F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in patients with active rheumatic diseases such as rheumatoid arthritis, spondyloarthritis, polymyalgia rheumatica, adult-onset Still's disease, relapsing polychondritis, immunoglobulin G4-related disease, large-vessel vasculitis, Wegener's granulomatosis, polymyositis, and dermatomyositis. We also discuss the role of FDG-PET/CT in the diagnosis and monitoring of these diseases.

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18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images at diagnosis and after steroid treatment in a patient with large-vessel vasculitis. (A) FDG-PET/CT at diagnosis identifies aortitis in the thoracic and abdominal aorta and arteritis bilaterally in the subclavian and axillary vessels as strong uptake in the walls of the aorta and arteries. (B) Update decreased markedly during steroid treatment.
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Fig6: 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images at diagnosis and after steroid treatment in a patient with large-vessel vasculitis. (A) FDG-PET/CT at diagnosis identifies aortitis in the thoracic and abdominal aorta and arteritis bilaterally in the subclavian and axillary vessels as strong uptake in the walls of the aorta and arteries. (B) Update decreased markedly during steroid treatment.

Mentions: Typical FDG-PET/CT images of large-vessel vasculitis (LVV) are shown in FigureĀ 6 [45]. From a systematic review on FDG-PET/CT in patients with LVV, Treglia and colleagues [46] drew several conclusions. First, FDG-PET/CT appears to be useful in early diagnosis and in the assessment of disease activity and extent. Second, the correlation between FDG-PET findings and serological inflammatory markers as well as the usefulness of FDG-PET/CT in evaluating treatment response require further investigation. Additionally, FDG-PET/CT appears to be superior to conventional imaging methods, such as US or MRI, in the diagnosis of LVV but not in predicting relapse or evaluating vascular complications. Lastly, PET analysis and diagnostic criteria should be standardized to allow reproducible, directly comparable results.Figure 6


Clinical value of whole-body PET/CT in patients with active rheumatic diseases.

Yamashita H, Kubota K, Mimori A - Arthritis Res. Ther. (2014)

18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images at diagnosis and after steroid treatment in a patient with large-vessel vasculitis. (A) FDG-PET/CT at diagnosis identifies aortitis in the thoracic and abdominal aorta and arteritis bilaterally in the subclavian and axillary vessels as strong uptake in the walls of the aorta and arteries. (B) Update decreased markedly during steroid treatment.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4289312&req=5

Fig6: 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) images at diagnosis and after steroid treatment in a patient with large-vessel vasculitis. (A) FDG-PET/CT at diagnosis identifies aortitis in the thoracic and abdominal aorta and arteritis bilaterally in the subclavian and axillary vessels as strong uptake in the walls of the aorta and arteries. (B) Update decreased markedly during steroid treatment.
Mentions: Typical FDG-PET/CT images of large-vessel vasculitis (LVV) are shown in FigureĀ 6 [45]. From a systematic review on FDG-PET/CT in patients with LVV, Treglia and colleagues [46] drew several conclusions. First, FDG-PET/CT appears to be useful in early diagnosis and in the assessment of disease activity and extent. Second, the correlation between FDG-PET findings and serological inflammatory markers as well as the usefulness of FDG-PET/CT in evaluating treatment response require further investigation. Additionally, FDG-PET/CT appears to be superior to conventional imaging methods, such as US or MRI, in the diagnosis of LVV but not in predicting relapse or evaluating vascular complications. Lastly, PET analysis and diagnostic criteria should be standardized to allow reproducible, directly comparable results.Figure 6

Bottom Line: Positron emission tomography (PET) provides highly sensitive, quantitative imaging at a molecular level, revealing the important pathophysiological processes underlying inflammation.This review provides an overview of the current utility of 18 F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in patients with active rheumatic diseases such as rheumatoid arthritis, spondyloarthritis, polymyalgia rheumatica, adult-onset Still's disease, relapsing polychondritis, immunoglobulin G4-related disease, large-vessel vasculitis, Wegener's granulomatosis, polymyositis, and dermatomyositis.We also discuss the role of FDG-PET/CT in the diagnosis and monitoring of these diseases.

View Article: PubMed Central - PubMed

Affiliation: Division of Rheumatic Diseases, National Center for Global Health and Medicine, 1-21-1, Toyama Shinjuku-ku, Tokyo 162-8655, Japan. hiroyuki_yjp2005@yahoo.co.jp

ABSTRACT
Advanced imaging techniques may enable early diagnosis and monitoring of therapy in various rheumatic diseases. To prevent irreversible tissue damage, inflammatory rheumatic disease must be diagnosed and treated in pre-clinical stages, requiring highly sensitive detection techniques. Positron emission tomography (PET) provides highly sensitive, quantitative imaging at a molecular level, revealing the important pathophysiological processes underlying inflammation. This review provides an overview of the current utility of 18 F-fluorodeoxyglucose (FDG)-PET/computed tomography (CT) in patients with active rheumatic diseases such as rheumatoid arthritis, spondyloarthritis, polymyalgia rheumatica, adult-onset Still's disease, relapsing polychondritis, immunoglobulin G4-related disease, large-vessel vasculitis, Wegener's granulomatosis, polymyositis, and dermatomyositis. We also discuss the role of FDG-PET/CT in the diagnosis and monitoring of these diseases.

Show MeSH
Related in: MedlinePlus