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Clinical value of 18F-FDG PET/CT in IgG4-related disease

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Annals of Nuclear Medicine Aims and scope Submit manuscript

Abstract

Objective

To investigate the clinical value of 18F-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) in IgG4-related disease (IgG4-RD).

Methods

Seventy two patients diagnosed with IgG4-RD who underwent PET/CT were included. Correlations between clinical variables and PET/CT findings were analyzed by Spearman’s correlation test. Conventional radiology was compared to PET/CT to evaluate detection discrepancies. The detection ability of insidious organ involvement by PET/CT at disease onset was investigated. The utility value of PET/CT for the 2019 ACR/EULAR classification criteria was analyzed with the multivariate logistic analysis and ROC curve.

Results

SUVmax of main involved organ was positively correlated with IgG4-RD Responder Index (IgG4-RD RI), serum and tissue IgG4 levels and IgG4/IgG ratio, serum eosinophils counts and number of involved organs, while negatively correlated with serum IgM levels. PET/CT was superior in detecting organ/tissue involvements including prostate, gastrointestinal tract and lung compared with conventional imaging. For patients with pancreato-hepato-biliary or head-neck involvements at onset, PET/CT showed superiority in detecting insidious lesions. Multivariate analysis showed that disease duration, multiple-organ involvement, SUVmax of main involved organ and mean SUVmax of all involved organs were significantly associated with the fulfillment of the 2019 ACR/EULAR classification criteria. ROC curves indicated that the cut-off value for SUVmax of main involved organ and mean SUVmax of all involved organs for fulfillment of the 2019 ACR/EULAR classification criteria for IgG4-RD were 4.1 and 3.5, respectively.

Conclusion

18F-FDG PET/CT has potential capacity to monitor disease activity, evaluate organ involvements and assist in the classification criteria in IgG4-RD.

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Data availability

Data are available upon reasonable request.

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Acknowledgements

We thank the patients, investigators, and study staff who were involved in these studies. BZQ and ZTS wrote the manuscript. YZH, CY, and DLL edited and revised the manuscript. All authors contributed to the article and approved the submitted version.

Funding

This work was supported by National Natural Science Foundation of China (No. 81771754 to L. L. Dong), Tongji Hospital Clinical Research Flagship Program (No. 2019CR206 to L. L. Dong)

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Author notes

  1. Zhiqian Bai and Tianshu Zhou have contributed equally to this work and share first authorship.

Authors and Affiliations

  1. Department of Rheumatology and Immunology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095th Jiefang Avenue, Wuhan, 430022, Hubei, China

    Zhiqian Bai, Tianshu Zhou, Yu Chen & Lingli Dong

  2. Department of Pathology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Zhihua Yu

Authors
  1. Zhiqian Bai
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  4. Yu Chen
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  5. Lingli Dong
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Contributions

BZQ and ZTS conducted the literature search. The study was designed by DLL and CY. BZQ, ZTS and YZH implemented the study and collected data with guidance from DLL.

Corresponding authors

Correspondence to Yu Chen or Lingli Dong.

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Conflict of interest

The authors have no conflicts of interest for this study.

Ethical approval

The study was approved by the Institutional Review Board of Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology (the approve number: 2021-S011).

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Not applicable.

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Bai, Z., Zhou, T., Yu, Z. et al. Clinical value of 18F-FDG PET/CT in IgG4-related disease. Ann Nucl Med 36, 651–660 (2022). https://doi.org/10.1007/s12149-022-01749-1

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  • DOI: https://doi.org/10.1007/s12149-022-01749-1

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