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Performance of the PET vascular activity score (PETVAS) for qualitative and quantitative assessment of inflammatory activity in Takayasu’s arteritis patients

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Abstract

Purpose

To assess the performance of PET vascular activity score (PETVAS) in comparison with SUVmax, inflammatory biomarkers and ITAS-2010 score in a cohort of TAK patients.

Methods

Sixty-four PET/CT scans acquired from 54 TAK patients were analyzed. The inflammatory activity was qualitatively determined by physician’s global assessment and quantitatively determined by ITAS-2010 score. SUVmax and PETVAS were acquired by consensus review. Levels of the inflammatory biomarkers C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), and pentraxin-3 (PTX-3) were measured. Performance of the qualitative diagnoses and the quantitative correlation were, respectively, compared by receiver operating characteristic (ROC) curve and Spearman correlation coefficient.

Results

The biomarkers (CRP, ESR, PTX-3), PET uptake values (SUVmax, PETVAS), and ITAS-2010 scores were all significantly higher in active patients than in non-active ones. The area under the ROC curve and Youden Index of PETVAS and PTX-3 were higher than those of SUVmax, CRP, ESR, and ITAS-2010. PETVAS and PTX-3 resulted in a higher Spearman correlation coefficient with ITAS-2010 than other criteria, either among all patients or within the active group. Alteration trends of PETVAS and PTX-3 during follow-up showed a tighter correlation with clinical progression/remission assessment than other criteria.

Conclusions

In TAK evaluation, PETVAS is superior for qualitative and quantitative assessment, compared with the regional SUVmax. Compared to CRP and ESR, inflammatory biomarker PTX-3 shows better qualitative performance and a higher correlation with PETVAS and ITAS-2010. These findings indicate that the use of PETVAS and PTX-3, instead of SUVmax and CRP/ESR, has potential advantages in the clinical evaluation of TAK.

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Acknowledgments

We would like to thank Mei Yang, Xiaohu Zhao, Zhiping Yang, Guiyu Li, Jin Zeng, and Zhiqin Li for their technical assistance.

Funding

This work was supported by the National Basic Research Program of China (No. 2015CB553704), the National Natural Science Foundation of China (Grant Nos. 81871379, 91959208, 81971646), the National Key Research and Development Program of China (Grant No. 2016YFC0103804), the Young Elite Scientists Sponsorship Program of China Association for Science and Technology (Grant No. 2017QNRC001).

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Author notes

  1. Fei Kang, Qing Han, Xiang Zhou and Zhaohui Zheng contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, Xijing Hospital, Fourth Military Medical University, No.127 West Changle Road,, Xi’an, China

    Fei Kang, Xiang Zhou, Shengjun Wang, Wenhui Ma, Zhiyong Quan, Weidong Yang & Jing Wang

  2. Department of Clinical Immunology, Xijing Hospital, Fourth Military Medical University, No.127 West Changle Road,, Xi’an, China

    Qing Han, Zhaohui Zheng, Kui Zhang & Ping Zhu

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  1. Fei Kang
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Correspondence to Jing Wang or Ping Zhu.

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All procedures performed in studies involving human participants and sample collection were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was approved by the Ethics Committee of Xijing Hospital (Approval No. KY20163015-1).

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Kang, F., Han, Q., Zhou, X. et al. Performance of the PET vascular activity score (PETVAS) for qualitative and quantitative assessment of inflammatory activity in Takayasu’s arteritis patients. Eur J Nucl Med Mol Imaging 47, 3107–3117 (2020). https://doi.org/10.1007/s00259-020-04871-2

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