Skip to main content
Log in

Role of F-18 FDG PET/CT in assessing IgG4-related disease with inflammation of head and neck glands

  • Original Article
  • Published:
Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Purpose

The aim of the current study was to evaluate the utility of F-18-fluoro-2-deoxy-d-glucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) in assessing patients diagnosed with immunoglobulin G4 (IgG4)-related disease (IgG4-RD) with inflammation of the head and neck glands.

Methods

We reviewed the records of 17 patients (16 men and 1 woman) with IgG4-RD exhibiting inflammation of the head and neck glands (lacrimal or salivary glands; LSG) who were diagnosed by excisional biopsy of the LSG. F-18 FDG PET/CT images were retrospectively evaluated for locations of high FDG accumulation, and the maximum standardized uptake value (SUVmax) of each lesion was calculated.

Results

In 15 of 17 patients (88 %), FDG accumulation was observed in organs outside of the biopsied LSG. High FDG accumulation was most frequently seen in the lymph node (71 %), followed by the non-biopsied LSG (41 %). FDG accumulation was also found in other typically affected organs including the prostate and retroperitoneum (18 %), kidney and lung (12 %), and pancreas (1 %). FDG accumulation was most commonly observed in two lesions outside of the biopsied site (41 %).

Conclusions

Detection of the multi-organ involvement before treatment is important for patients with IgG4-RD. F-18 FDG PET/CT is an effective tool for assessing the location of extra-LSG lesions in patients with IgG4-RD with LSG inflammation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Kamisawa T, Okamoto A. IgG4-related sclerosing disease. World J Gastroenterol. 2008;14:3948–55.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Umehara H. A new clinical entity: IgG4-related disease (IgG4-RD) discovered in the 21st century. Intern Med. 2012;51:821–2.

    Article  PubMed  Google Scholar 

  3. Umehara H, Okazaki K, Masaki Y, Kawano M, Yamamoto M, Saeki T, et al. Comprehensive diagnostic criteria for IgG4-related disease (IgG4-RD), 2011. Mod Rheumatol. 2012;22:21–30.

    Article  CAS  PubMed  Google Scholar 

  4. Fujita A, Sakai O, Chapman MN, Sugimoto H. IgG4-related disease of the head and neck: CT and MR imaging manifestations. Radiographics. 2012;32:1945–58.

    Article  PubMed  Google Scholar 

  5. Yamamoto M, Takahashi H, Sugai S, Imai K. Clinical and pathological characteristics of Mikulicz’s disease (IgG4-related plasmacytic exocrinopathy). Autoimmun Rev. 2005;4:195–200.

    Article  PubMed  Google Scholar 

  6. Tanaka A, Moriyama M, Nakashima H, Miyake K, Hayashida JN, Maehara T, et al. Th2 and regulatory immune reactions contribute to IgG4 production and the initiation of Mikulicz disease. Arthritis Rheum. 2012;64:254–63.

    Article  CAS  PubMed  Google Scholar 

  7. Basu S, Zhuang H, Torigian DA, Rosenbaum J, Chen W, Alavi A. Functional imaging of inflammatory diseases using nuclear medicine techniques. Semin Nucl Med. 2009;39:124–45.

    Article  PubMed  Google Scholar 

  8. Sato M, Okumura T, Shioyama Y, Imura J. Extrapancreatic F-18 FDG accumulation in autoimmune pancreatitis. Ann Nucl Med. 2008;22:215–9.

    Article  PubMed  Google Scholar 

  9. Kawamura E, Habu D, Higashiyama S, Tsushima H, Shimonishi Y, Nakayama Y, et al. A case of sclerosing cholangitis with autoimmune pancreatitis evaluated by FDG-PET. Ann Nucl Med. 2007;21:223–8.

    Article  PubMed  Google Scholar 

  10. Nakajo M, Jinnouchi S, Fukukura Y, Tanabe H, Tateno R, Nakajo M. The efficacy of whole-body FDG-PET or PET/CT for autoimmune pancreatitis and associated extrapancreatic autoimmune lesions. Eur J Nucl Med Mol Imaging. 2007;34:2088–95.

    Article  PubMed  Google Scholar 

  11. Toyoda K, Oba H, Kutomi K, Furui S, Oohara A, Mori H, et al. MR imaging of IgG4-related disease in the head and neck and brain. AJNR Am J Neuroradiol. 2012;33:2136–9.

    Article  CAS  PubMed  Google Scholar 

  12. Yamamoto M, Takahashi H, Ishigami K, Yajima H, Shimizu Y, Tabeya T, et al. Relapse patterns in IgG4-related disease. Ann Rheum Dis. 2012;71:1755.

    Article  CAS  PubMed  Google Scholar 

  13. Taniguchi Y, Ogata K, Inoue K, Terada Y. Clinical implication of FDG-PET/CT in monitoring disease activity in IgG4-related disease. Rheumatology. 2013;52:1508.

    Article  PubMed  Google Scholar 

  14. Zhang J, Chen H, Ma Y, Xiao Y, Niu N, Lin W, et al. Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study. Eur J Nucl Med Mol Imaging. 2014;41:1624–34.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  15. Nakatani K, Nakamoto Y, Togashi K. Utility of FDG PET/CT in IgG4-related systemic disease. Clin Radiol. 2012;67:297–305.

    Article  CAS  PubMed  Google Scholar 

  16. Ebbo M, Grados A, Guedj E, Gobert D, Colavolpe C, Zaidan M, et al. Usefulness of 2-[18F]-fluoro-2-deoxy-d-glucose-positron emission tomography/computed tomography for staging and evaluation of treatment response in IgG4-related disease: a retrospective multicenter study. Arthritis Care Res (Hoboken). 2014;66(1):86–96.

    Article  CAS  Google Scholar 

Download references

Conflict of interest

There is no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Azusa Tokue.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tokue, A., Higuchi, T., Arisaka, Y. et al. Role of F-18 FDG PET/CT in assessing IgG4-related disease with inflammation of head and neck glands. Ann Nucl Med 29, 499–505 (2015). https://doi.org/10.1007/s12149-015-0969-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12149-015-0969-3

Keywords

Navigation