18F-FDG PET/CT in patients with adult-onset Still’s disease
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18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) has become useful for the detection and diagnosis of inflammatory conditions, including rheumatic diseases, immunoglobulin (Ig) G4-related disease and giant cell arteritis. However, few articles based on small sample sizes (n = 7) diagnosed as adult-onset Still’s disease (AOSD) have been published. The study aim was to observe the reliable characteristics and usefulness of 18F-FDG PET/CT for the evaluation of consecutive patients with AOSD. Eligible patients were selected from among those who had undergone 18F-FDG PET/CT between May 2007 and June 2014. Twenty-six consecutive AOSD patients were recruited retrospectively according to criteria set by Yamaguchi et al. All patients underwent evaluation by 18F-FDG PET/CT. The characteristics and usefulness of 18F-FDG PET/CT for evaluation of consecutive patients with AOSD were evaluated. All 26 patients had 18F-FDG-avid lesion(s) related to their particular disease. Diffuse and homogeneous accumulation of 18F-FDG was seen in the bone marrow (26/26; 100 %; maximum standardized uptake (SUVmax), 2.10–6.73) and spleen (25/26; 96.15 %). The SUVmax of affected lymph nodes was 1.3–9.53 (mean ± SD, 4.12 ± 2.24). The SUVmax and size factors (maximum diameter and areas) of affected lymph nodes were significantly different (P = 0.033 and P = 0.012, respectively). 18F-FDG PET/CT showed the general distribution of 18F-FDG accumulation. This factor helped to exclude malignant disease and aided the diagnosis of AOSD (42.3 %) in 11 cases when combined with clinical features and aided decisions regarding appropriate biopsy sites, such as the lymph nodes (n = 9) and bone marrow (n = 13). 18F-FDG PET/CT is a unique imaging method for the assessment of metabolic activity throughout the body in subjects with AOSD. Characteristics or patterns of AOSD observed on 18F-FDG PET/CT can be used for the indication and diagnosis or to guide the clinical management of ASOD.
KeywordsAdult-onset Still’s disease Bone marrow Diagnosis 18F-FDG PET/CT Lymph nodes
This study was supported by the National Natural Science Foundation of China (No. 81471704), the Science and Technology Planning Project of Zhejiang Province (2013C33119) and the Health Bureau Project of Zhejiang Province (2013KYA069, 2013ZDA008).
Conflict of interest
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