Diagnosis of polymyalgia rheumatica and giant cell arteritis using FDG PET and PET / CT imaging – Twelve-year experience of one diagnostic center
Authors:
Z. Řehák 1,2; Z. Fojtík 3; J. Vašina 1; R. Koukalová 1; Z. Bortlíček 4; A. Vavrušová 5; P. Němec 6
Authors‘ workplace:
Oddělení nukleární medicíny a PET centrum, Masarykův onkologický ústav, Brno
1; Regionální centrum aplikované molekulární onkologie, Masarykův onkologický ústav, Brno
2; Revmatologická ambulance, Interní hematologická a onkologická klinika, FN Brno a Lékařská fakulta Masarykovy univerzity, Brno
3; Institut biostatistiky a analýz, Lékařská fakulta Masarykovy univerzity, Brno
4; Interní oddělení, Nemocnice Třebíč
5; Revmatologická ambulance, II. interní klinika, FN U sv. Anny, Lékařská fakulta Masarykovy univerzity, Brno
6
Published in:
Čes. Revmatol., 26, 2018, No. 3, p. 122-130.
Category:
Original article
Overview
Polymyalgia rheumatica (PMR) is a chronic, inflammatory disease of unknown cause. Giant cell arteritis (GCA) is a systemic vasculitis affecting medium- and large-sized arteries such as temporal arteries or the aorta and its branches. Diagnosis of these two clinical units could be performed by 18F-FDG PET / CT. The potential of this examination method lies in the ability to detect early inflammatory changes that can be affected by therapy before the development of permanent changes.
A total of 89 patients, 36 (40.4 %) men and 53 (59.6 %) women aged 47-83 years with a median of 69 years, who met the classification criteria for polymyalgia rheumatica, were enrolled. Vascular involvement was detected in 33 (37.1 %) patients in 2-7 (median 4) examined areas of the large arteries. A total of 81 (91.0 %) patients were affected by proximal joint involvement, specifically: shoulder joints in 78 (87.6 %) patients, hip joints in 65 (73.0%) and sternoclavicular joints in 45 (50.6 %) patients. The finding of extraarticular synovial structure involvement was detected in 75 (84.3 %) patients, especially in these localizations: ischial tuberosities or ischiogluteal bursae in 48 (53.9 %) patients, the area between the spinal processes of the lumbar spine in 42 (47.2 %) patients, the area between the spinal processes of the cervical spine in 27 (30.3 %) patients, the subtrochanteric area in 41 (46.1 %) patients, and symphysis in 23 (25.8%) patients.
FDG PET / CT seems to be an advantageous "one-step" examination that can detect the extent of activity in the entire area, can detect PMR or GCA in many forms of these diseases, and is also able to provide evidence of the absence of tumors.
Key words:
FDG, PET, PET/CT, polymyalgia rheumatica, giant cell arteritis
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Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
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