F-18 FDG PET/CT in the evaluation of Takayasu arteritis: An experience from the tropics
- 393 Downloads
To evaluate the performance parameters of FDG PET/CT in patients with Takayasu arteritis at diagnosis and during immunosuppression.
Retrospective analysis of 60 FDG PET/CT studies in 51 patients was performed (17 scans at diagnosis out of which 4 had follow-up scans also and 43 scans on immunosuppression). The degree of FDG uptake in the vessels was assessed visually using a 4-point scale and maximum standardized uptake value (SUVmax), SUVratio, extent of vasculitis and association with ESR were calculated.
PET/CT was positive for active vasculitis in all 17 patients at diagnosis. The mean SUVmax and mean SUV ratio of the active areas were 5.1 ± 3.0 and 3.2 ± 1.9, respectively. On immunosuppression, PET scan was positive for active vasculitis in 14/43 (32.5%) scans. The mean SUVmax and mean SUVratio of the active areas were 1.7 ± 2.1 and 0.95 ± 1.2, respectively. There was significant difference between the mean SUVmax and mean SUVratio at diagnosis and on immunosuppression, respectively (P < .01). The median number of vascular segments in each uptake grade group was also statistically different (P < .01) between scans at diagnosis and on immunosuppression. The median ESR level in PET positive scans was 29 mm/hour (2-53), whereas in PET negative scans was 35.5 mm/hour (6-50) and the difference was not statistically significant.
FDG PET/CT showed good sensitivity to detect active vasculitis at diagnosis and during immunosuppression. The change in SUVmax between the successive FDG PET/CT scans may give an objective assessment of response to immunosuppression.
KeywordsTakayasu arteritis vasculitis immunosupression FDG PET/CT
Conflict of interest
The authors declare that they have no conflict of interest.
The authors have no direct or indirect commercial/financial incentive associated with publishing the article. No funding has been received for this work from any of the organizations.
- 1.Langford CA, Fauci AS. The vasculitis syndromes. In: Fauci Longo, Hauser Kasper, Loscalzo Jameson, editors. Harrison’s principles of internal medicine. 18th ed. New York: McGraw Hill; 2012. p. 2116.Google Scholar