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PET/MRI in large-vessel vasculitis: clinical value for diagnosis and assessment of disease activity
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PET/MRI in large-vessel vasculitis: clinical value for diagnosis and assessment of disease activity
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Journal Article
PET/MRI in large-vessel vasculitis: clinical value for diagnosis and assessment of disease activity
2019
Overview
Diagnosis of large vessel vasculitis (LVV) and evaluation of its inflammatory activity can be challenging. Our aim was to investigate the value of hybrid positron-emission tomography/magnetic resonance imaging (PET/MRI) in LVV. All consecutive patients with LVV from the Department of Internal Medicine who underwent PET/MRI were included. Three PET/MRI patterns were defined: (i) “inflammatory,” with positive PET (>liver uptake) and abnormal MRI (stenosis and/or wall thickening); (ii) “fibrous”, negative PET (≤liver uptake) and abnormal MRI; and (iii) “normal”. Thirteen patients (10 female; median age: 67-years [range: 23–87]) underwent 18 PET/MRI scans. PET/MRI was performed at diagnosis (n = 4), at relapse (n = 7), or during remission (n = 7). Among the 18 scans, eight (44%) showed an inflammatory pattern and three (17%) a fibrous pattern; the other seven were normal. The distribution of the three patterns did not differ between patients with Takayasu arteritis (TA, n = 10 scans) and those with giant cell arteritis (GCA, n = 8 scans). PET/MRI findings were normal in 2/10 (20%) TA scans vs. 5/8 (62%) GCA scans (p = 0.3). Median SUV
max
was 4.7 [2.1–8.6] vs. 2 [1.8–2.6] in patients with active disease vs. remission, respectively (p = 0.003). PET/MRI is a new hybrid imaging modality allowing comprehensive and multimodal analysis of vascular wall inflammation and the vascular lumen. This technique offers promising perspectives for the diagnosis and monitoring of LVV.
Publisher
Nature Publishing Group UK,Nature Publishing Group
Subject
/ 692/699
/ Adult
/ Aged
/ Cardiology and cardiovascular system
/ Female
/ Fibrosis
/ Fluorodeoxyglucose F18 - chemistry
/ Giant Cell Arteritis - diagnosis
/ Giant Cell Arteritis - diagnostic imaging
/ Giant Cell Arteritis - pathology
/ Humanities and Social Sciences
/ Humans
/ Image Processing, Computer-Assisted
/ Imaging
/ Inflammation - complications
/ Liver
/ Male
/ NMR
/ Positron emission tomography
/ Science
/ Stenosis
/ Takayasu Arteritis - diagnosis
/ Takayasu Arteritis - diagnostic imaging
