Annals of Nuclear Medicine

, Volume 23, Issue 3, pp 311–316 | Cite as

Therapeutic effects of acupuncture in patients with rheumatoid arthritis: a prospective study using 18F-FDG–PET

  • Masami Sato
  • Masayuki InubushiEmail author
  • Tohru Shiga
  • Kenji Hirata
  • Shozo Okamoto
  • Tomohito Kamibayashi
  • Kazuhide Tanimura
  • Nagara Tamaki
Original Article



The purpose of this study was to investigate whether improvement of regional inflammatory findings in knee joints of rheumatoid arthritis (RA) could be detected by positron-emission tomography (PET) using 18F-Fluorodeoxyglucose (FDG) after acupuncture treatments, as well as improvement of systemic inflammatory markers.


Six RA patients (all female, 61 ± 12 years old) received 10 acupuncture treatments in 2 months, to 11 traditional acupuncture points around a knee joint considered effective on RA. A visual analogue scale (VAS) for intensity of pain, knee joint range of motion (ROM), face scale for patient mood, and modified health assessment questionnaire (MHAQ) for disability of daily activities were assessed just before and after acupuncture. Maximum standardized uptake value (SUVmax) and the volume with SUV more than 1.0 [Volume(SUV > 1)] on FDG–PET images as well as erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) levels were also measured before and after the treatments.


VAS, ROM, face scale and MHAQ improved in all patients and significantly after acupuncture, but no significant change was detected in ESR, CRP, SUVmax, or Volume(SUV > 1).


Acupuncture relieves symptom, remedies physical function, and improves quality of life in RA patients, but may have no or very limited anti-inflammatory effect systemically. The regional effects of acupuncture are unlikely to be induced through reduction of regional inflammation. We believe this clinical study is the first step for elucidating therapeutic mechanisms of acupuncture, which must be important for the rational use and further development of acupuncture.


Acupuncture Rheumatoid arthritis 18F-Fluorodeoxyglucose (18F-FDG) Positron-emission tomography (PET) Treatment outcome 



We thank Dr. Chietsugu Kato of Department of Health Sciences, Hokkaido University, Sapporo, and Dr. Koichi Morita of Sousei Higashi Hospital, Sapporo for their assistance.


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Copyright information

© The Japanese Society of Nuclear Medicine 2009

Authors and Affiliations

  • Masami Sato
    • 1
    • 2
  • Masayuki Inubushi
    • 3
    Email author
  • Tohru Shiga
    • 1
  • Kenji Hirata
    • 1
  • Shozo Okamoto
    • 1
  • Tomohito Kamibayashi
    • 1
  • Kazuhide Tanimura
    • 4
  • Nagara Tamaki
    • 1
  1. 1.Department of Nuclear MedicineHokkaido University Graduate School of MedicineSapporoJapan
  2. 2.Shirakaba Acupuncture Moxibustion and OsteopathySapporoJapan
  3. 3.Diagnostic Imaging Group, Molecular Imaging CenterNational Institute of Radiological SciencesChibaJapan
  4. 4.Rheumatic and Collagen Disease CenterTokeidai Memorial HospitalSapporoJapan

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