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Large Vessel Vasculitis

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FDG-PET/CT and PET/MR in Cardiovascular Diseases

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Abstract

2-[18F] fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) has become part of the worldwide standard of care in oncology. For a decade, this functional imaging tool has also demonstrated important diagnostic results in inflammatory diseases, especially in large vessel vasculitis (LVV). Since clinical PET imaging is increasingly used in these two conditions, this chapter aims to assist imaging specialists and clinicians by getting acquainted with the PET imaging procedures and the current status in clinical practice for LVV. General background information, PET technical considerations (including patient preparation, imaging protocols, scoring methodology), diagnostic and prognostic performance, and response monitoring will be addressed, in line with recent international expert-based recommendations. Also, in the era of personalized medicine, new hybrid technologies such as PET/MR and PET radiotracers will be discussed.

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References

  1. Weyand CM, Goronzy JJ. Immune mechanisms in medium and large-vessel vasculitis. Nat Rev Rheumatol. 2013;9:731. http://www.ncbi.nlm.nih.gov/pubmed/24189842.

    Article  CAS  Google Scholar 

  2. Watanabe R, Berry GJ, Liang DH, Goronzy JJ, Weyand CM. Pathogenesis of Giant cell arteritis and Takayasu arteritis—similarities and differences. Curr Rheumatol Rep. 2020;22(10):68.

    Article  Google Scholar 

  3. Jennette J. Overview of the 2012 revised international Chapel Hill consensus conference nomenclature of vasculitides. Clin Exp Nephrol. 2013;17:603–6. http://www.ncbi.nlm.nih.gov/pubmed/24072416.

    Article  Google Scholar 

  4. Blockmans D, Stroobants S, Maes A, Mortelmans L. Positron emission tomography in giant cell arteritis and polymyalgia rheumatica: evidence for inflammation of the aortic arch. Am J Med. 2000;108:246–9.

    Article  CAS  Google Scholar 

  5. Dejaco C, Ramiro S, Duftner C, Besson FL, Bley TA, Blockmans D, et al. EULAR recommendations for the use of imaging in large vessel vasculitis in clinical practice. Ann Rheum Dis. 2018;77:636–43. https://doi.org/10.1136/annrheumdis-2017-212649.

    Article  PubMed  Google Scholar 

  6. Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med. 1992;33:1972–80. http://www.ncbi.nlm.nih.gov/pubmed/1432158.

    CAS  PubMed  Google Scholar 

  7. Marano SR, Fischer DW, Gaines C, VKH S. Anatomical study of the superficial temporal artery. Neurosurgery. 1985;16:786–90. https://academic.oup.com/neurosurgery/article/16/6/786/2752637.

    Article  CAS  Google Scholar 

  8. Slart RHJA, Glaudemans AWJM, Chareonthaitawee P, Treglia G, Besson FL, Bley TA, et al. FDG-PET/CT (a) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET interest group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018;45:1250–69.

    Article  Google Scholar 

  9. Nielsen BD, Hansen IT, Kramer S, Haraldsen A, Hjorthaug K, Bogsrud TV, et al. Simple dichotomous assessment of cranial artery inflammation by conventional 18F-FDG PET/CT shows high accuracy for the diagnosis of giant cell arteritis: a case-control study. Eur J Nucl Med Mol Imaging. 2019;46:184–93. http://link.springer.com/10.1007/s00259-018-4106-0.

    Article  CAS  Google Scholar 

  10. Nienhuis PH, Sandovici M, Glaudemans AW, Slart RH, Brouwer E. Visual and semiquantitative assessment of cranial artery inflammation with FDG-PET/CT in giant cell arteritis. Semin Arthritis Rheum. 2020;50:616–23. https://linkinghub.elsevier.com/retrieve/pii/S0049017220300986.

    Article  CAS  Google Scholar 

  11. Sammel AM, Hsiao E, Schembri G, Bailey E, Nguyen K, Brewer J, et al. Cranial and large vessel activity on positron emission tomography scan at diagnosis and 6 months in giant cell arteritis. Int J Rheum Dis. 2020;23:582–8.

    Article  CAS  Google Scholar 

  12. Slart RHJA, Glaudemans AWJM, Gheysens O, Lubberink M, Kero T. Procedural recommendations of cardiac PET/CT imaging: and innervation (4Is) -related cardiovascular diseases: a joint collaboration of the EACVI and the EANM. Eur J Nucl Med Mol Imaging. 2020;48(4):1016–39.

    Article  Google Scholar 

  13. Bucerius J, Mani V, Moncrieff C, Machac J, Fuster V, Farkouh ME, et al. Optimizing 18F-FDG PET/CT imaging of vessel wall inflammation: the impact of 18F-FDG circulation time, injected dose, uptake parameters, and fasting blood glucose levels. Eur J Nucl Med Mol Imaging. 2014;41:369–83.

    Article  CAS  Google Scholar 

  14. Wahl L, Henry A, Ethier P. Glucose: effects on tumor and normal in rodents mammary. Radiology. 1992;183:643–7.

    Article  CAS  Google Scholar 

  15. Rabkin Z, Israel O, Keidar Z. Do hyperglycemia and diabetes affect the incidence of false-negative 18F-FDG PET/CT studies in patients evaluated for infection or inflammation and cancer? A comparative analysis. J Nucl Med. 2010;51:1015–20.

    Article  Google Scholar 

  16. Hellmich B, Agueda A, Monti S, Buttgereit F, de Boysson H, Brouwer E, et al. 2018 update of the EULAR recommendations for the management of large vessel vasculitis. Ann Rheum Dis. 2020;79:19–130. https://doi.org/10.1136/annrheumdis-2019-215672.

    Article  PubMed  Google Scholar 

  17. Schmidt WA, Nielsen BD. Imaging in large-vessel vasculitis. Best Pract Res Clin Rheumatol. 2020;34:101589. https://doi.org/10.1016/j.berh.2020.101589.

    Article  PubMed  Google Scholar 

  18. Nielsen BD, Gormsen LC, Hansen IT, Keller KK, Therkildsen P, Hauge EM. Three days of high-dose glucocorticoid treatment attenuates large-vessel 18F-FDG uptake in large-vessel giant cell arteritis but with a limited impact on diagnostic accuracy. Eur J Nucl Med Mol Imaging. 2018;45:1119–28.

    Article  CAS  Google Scholar 

  19. Stellingwerff MD, Brouwer E, Lensen KJDF, Rutgers A, Arends S, van der Geest KSM, et al. Different scoring methods of FDG PET/CT in giant cell arteritis need for standardization. Medicine (Baltimore). 2015;94:1–9.

    Article  Google Scholar 

  20. Quinn KA, Rosenblum JS, Rimland CA, Gribbons KB, Ahlman MA, Grayson PC. Imaging acquisition technique influences interpretation of positron emission tomography vascular activity in large-vessel vasculitis. Semin Arthritis Rheum. 2020;50:71–6. https://doi.org/10.1016/j.semarthrit.2019.07.008.

    Article  CAS  PubMed  Google Scholar 

  21. Belhocine T, Blockmans D, Hustinx R, Vandevivere J, Mortelmans L. Imaging of large vessel vasculitis with 18FDG PET: illusion or reality? A critical review of the literature data. Eur J Nucl Med Mol Imaging. 2003;30(9):1305–13.

    Article  Google Scholar 

  22. Brodmann M, Lipp RW, Passath A, Seinost G, Pabst E, Pilger E. The role of 2-18F-fluoro-2-deoxy-d-glucose positron emission tomography in the diagnosis of giant cell arteritis of the temporal arteries. Rheumatology. 2004;43:241–2.

    Article  CAS  Google Scholar 

  23. Rimland CA, Quinn KA, Rosenblum JS, Schwartz MN, Bates Gribbons K, Novakovich E, et al. Outcome measures in large vessel vasculitis: relationship between patient-, physician-, imaging-, and laboratory-based assessments. Arthritis Care Res. 2020;72:1296–304. https://doi.org/10.1002/acr.24117.

    Article  Google Scholar 

  24. van der Geest KSM, Sandovici M, Brouwer E, Mackie SL. Diagnostic accuracy of symptoms, physical signs, and laboratory tests for giant cell arteritis: a systematic review and meta-analysis. JAMA Intern Med. 2020;180:1295–304.

    Article  Google Scholar 

  25. Walter MA, Melzer RA, Schindler C, Müller-Brand J, Tyndall A, Nitzsche EU. The value of [18F]FDG-PET in the diagnosis of large-vessel vasculitis and the assessment of activity and extent of disease. Eur J Nucl Med Mol Imaging. 2005;32:674–81. https://doi.org/10.1007/s00259-004-1757-9.

    Article  PubMed  Google Scholar 

  26. Duftner C, Dejaco C, Sepriano A, Falzon L, Schmidt WA, Ramiro S. Imaging in diagnosis, outcome prediction and monitoring of large vessel vasculitis: a systematic literature review and meta-analysis informing the EULAR recommendations. RMD Open. 2018;4:101589.

    Article  Google Scholar 

  27. Grayson PC, Alehashemi S, Bagheri AA, Civelek AC, Cupps TR, Kaplan MJ, et al. 18F-Fluorodeoxyglucose–positron emission tomography as an imaging biomarker in a prospective, longitudinal cohort of patients with large vessel vasculitis. Arthritis Rheumatol. 2018;70:439–49. https://doi.org/10.1002/art.40379.

    Article  PubMed  PubMed Central  Google Scholar 

  28. de Boysson H, Aide N, Liozon E, Lambert M, Parienti JJ, Monteil J, et al. Repetitive 18F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease. Eur J Intern Med. 2017;46:66–70.

    Article  Google Scholar 

  29. Meller J, Strutz F, Siefker U, Scheel A, Sahlmann CO, Lehmann K, et al. Early diagnosis and follow-up of aortitis with [18F] FDG PET and MRI. Eur J Nucl Med Mol Imaging. 2003;30:730–6. https://doi.org/10.1007/s00259-003-1144-y.

    Article  CAS  PubMed  Google Scholar 

  30. Iwabu M, Yamamoto Y, Dobashi H, Kameda T, Kittaka K, Nishiyama Y. F−18 FDG PET findings of Takayasu arteritis before and after immunosuppressive therapy. Clin Nucl Med. 2008;33:872–3. https://journals.lww.com/00003072-200812000-00014.

    Article  Google Scholar 

  31. Nienhuis PH, van Praagh GD, Glaudemans AWJM, Brouwer E, Slart RHJA. A review on the value of imaging in differentiating between large vessel vasculitis and atherosclerosis. J Pers Med. 2021;11:236. https://www.mdpi.com/2075-4426/11/3/236.

    Article  Google Scholar 

  32. Laurent C, Ricard L, Fain O, Buvat I, Adedjouma A, Soussan M, et al. PET/MRI in large-vessel vasculitis: clinical value for diagnosis and assessment of disease activity. Sci Rep. 2019;9:1–7. https://www.nature.com/articles/s41598-019-48709-w.

    Article  CAS  Google Scholar 

  33. Dellavedova L, Carletto M, Faggioli P, Sciascera A, del Sole A, Mazzone A, et al. The prognostic value of baseline 18F-FDG PET/CT in steroid-naïve large-vessel vasculitis: introduction of volume-based parameters. Eur J Nucl Med Mol Imaging. 2016;43:340–8. https://doi.org/10.1007/s00259-015-3148-9.

    Article  CAS  PubMed  Google Scholar 

  34. Jiemy WF, Heeringa P, Kamps JAAM, van der Laken CJ, Slart RHJA, Brouwer E. Positron emission tomography (PET) and single photon emission computed tomography (SPECT) imaging of macrophages in large vessel vasculitis: current status and future prospects. Autoimmun Rev. 2018;17:715–26.

    Article  Google Scholar 

  35. Windisch P, Zwahlen DR, Giesel FL, Scholz E, Lugenbiel P, Debus J, et al. Clinical results of fibroblast activation protein (FAP) specific PET for non-malignant indications: systematic review. EJNMMI Res. 2021;11(1):18.

    Article  Google Scholar 

  36. Hicks RJ, Roselt PJ, Kallur KG, Tothill RW, Mileshkin L. FAPI PET/CT: will it end the hegemony of 18F-FDG in oncology? J Nucl Med. 2021;62:296–302.

    Article  CAS  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Nuclear Medicine and Molecular Imaging, Medical Imaging Center, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Pieter H. Nienhuis & Riemer H. J. A. Slart

  2. Vasculitis Expertise Center Groningen, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Pieter H. Nienhuis, Elisabeth Brouwer & Riemer H. J. A. Slart

  3. Department of Rheumatology and Clinical Immunology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Elisabeth Brouwer

  4. Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, The Netherlands

    Riemer H. J. A. Slart

Authors
  1. Pieter H. Nienhuis
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Correspondence to Riemer H. J. A. Slart .

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Editors and Affiliations

  1. Montreal Heart Institute, Montréal, QC, Canada

    Matthieu Pelletier-Galarneau

  2. BC Cancer Agency, Vancouver, BC, Canada

    Patrick Martineau

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Nienhuis, P.H., Brouwer, E., Slart, R.H.J.A. (2022). Large Vessel Vasculitis. In: Pelletier-Galarneau, M., Martineau, P. (eds) FDG-PET/CT and PET/MR in Cardiovascular Diseases. Springer, Cham. https://doi.org/10.1007/978-3-031-09807-9_7

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  • DOI: https://doi.org/10.1007/978-3-031-09807-9_7

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  • Online ISBN: 978-3-031-09807-9

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