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Cranial and large vessel activity on positron emission tomography scan at diagnosis and 6 months in giant cell arteritis
Author(s) -
Sammel Anthony M.,
Hsiao Edward,
Schembri Geoffrey,
Bailey Elizabeth,
Nguyen Katherine,
Brewer Janice,
Schrieber Leslie,
Janssen Beatrice,
Youssef Peter,
Fraser Clare L.,
Laurent Rodger
Publication year - 2020
Publication title -
international journal of rheumatic diseases
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.795
H-Index - 41
eISSN - 1756-185X
pISSN - 1756-1841
DOI - 10.1111/1756-185x.13805
Subject(s) - medicine , giant cell arteritis , interquartile range , positron emission tomography , vasculitis , arteritis , aortitis , claudication , radiology , nuclear medicine , vascular disease , surgery , arterial disease , aorta , disease
Aim Positron emission tomography/computed tomography (PET/CT) can detect cranial and large vessel inflammation in giant cell arteritis (GCA). We aimed to determine the change and significance of vascular activity at diagnosis and 6 months. Method Newly diagnosed GCA patients underwent time‐of‐flight fluorine‐18‐fluoro‐2‐deoxyglucose PET/CT from vertex to diaphragm within 72 hours of commencing corticosteroids and were followed for 12 months. A 6 months scan was performed in patients with inflammatory features on biopsy or CT aortitis. Vascular uptake was visually graded by 2 blinded readers across 18 artery segments from 0 (no increased uptake) to 3 (very marked uptake). Scores were summed to give a total vascular score (TVS). Results We enrolled 21 GCA patients and 15 underwent the serial scan. Twelve (57%) patients experienced a relapse and 5 of these had ischemic features of vision disturbance, jaw or limb claudication. The median TVS fell from 14 (interquartile range [IQR] 4‐24) at baseline to 5 (IQR 0‐10) at 6 months ( P < .01) with reduction in both cranial and large artery scores. While the overall relapse rate was similar between patients with a high (≥10) and low baseline TVS, patients with high scores were numerically more likely to experience an ischemic relapse (33% vs 11%, P = .34). Five out of 15 patients had persistent uptake in at least 1 vessel on the serial PET/CT but none experienced a subsequent relapse. Conclusion Vascular activity decreased in cranial and large arteries between diagnosis and 6 months. Persistent activity did not predict subsequent relapse.