Total metabolic lesion volume of lymph nodes measured by ¹⁸F-FDG PET/CT: a new predictor of macrophage activation syndrome in adult-onset Still's disease.

IF 4.4 2区医学 Q1 RHEUMATOLOGY Arthritis Research & Therapy Pub Date : 2021-03-30 DOI:10.1186/s13075-021-02482-2

Liyan Wan, Yuting Gao, Jieyu Gu, Huihui Chi, Zhihong Wang, Qiongyi Hu, Jinchao Jia, Tingting Liu, Biao Li, Jialin Teng, Honglei Liu, Xiaobing Cheng, Junna Ye, Yutong Su, Chengde Yang, Hui Shi, Min Zhang

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引用次数: 6

Abstract

Background: To investigate the potential utility of quantitative parameters obtained by ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography (¹⁸F-FDG PET/CT) in the assessment of disease severity and the occurrence of macrophage activation syndrome (MAS) in adult-onset Still's disease (AOSD).

Methods: Fifty-seven patients with AOSD who underwent pre-treatment ¹⁸F-FDG PET/CT were recruited in this study and compared with 60 age- and sex-matched healthy controls. Clinical features and laboratory data were recorded. The systemic score was assessed to determine the disease severity. The maximal standardized uptake value (SUV_max), metabolic lesion volume (MLV), and total lesion glycolysis (TLG) were used to evaluate the involved organs and tissues that abnormally accumulated ¹⁸F-FDG. Multivariate analysis was performed to identify the PET/CT-derived risk factors contributing to the AOSD-related MAS, and their diagnostic efficiency was evaluated.

Results: High ¹⁸F-FDG accumulation was observed in the bone marrow (SUV_max median, 5.10), spleen (SUV_max median, 3.70), and lymph nodes (LNs, SUV_max median, 5.55). The SUV_max of the bone marrow (rho = 0.376, p = 0.004), SUV_max of the spleen (rho = 0.450, p < 0.001), TLG_total of LNs (rho = 0.386, p = 0.017), and MLV_total of LNs (rho = 0.391, p = 0.015) were correlated with the systemic score. The SUV_max of the spleen (p = 0.017), TLG_total of LNs (p = 0.045), and MLV_total of LNs (p = 0.012) were higher in patients with MAS than in those without MAS. A MLV_total of LNs > 62.2 (OR 27.375, p = 0.042) was an independent predictive factor for MAS with a sensitivity of 80.0% and a specificity of 93.9%.

Conclusions: The glucose metabolic level of the spleen could be an effective and easy-to-use imaging indicator of disease severity, and MLV_total of LNs > 62.2 was a strong predictor of MAS occurrence in patients with AOSD.

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18F-FDG PET/CT测量淋巴结总代谢病变体积:成人发病斯蒂尔氏病巨噬细胞激活综合征的新预测指标

背景:研究18f -氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描(18F-FDG PET/CT)获得的定量参数在评估成人发病Still病(AOSD)的疾病严重程度和巨噬细胞激活综合征(MAS)发生中的潜在效用。方法:本研究招募了57例接受治疗前18F-FDG PET/CT的AOSD患者，并与60名年龄和性别匹配的健康对照组进行了比较。记录临床特征和实验室数据。评估系统评分以确定疾病的严重程度。采用最大标准化摄取值(SUVmax)、代谢病变体积(MLV)和病变总糖酵解(TLG)来评估异常积累18F-FDG的受累器官和组织。通过多变量分析确定PET/ ct衍生的导致aosd相关MAS的危险因素，并评估其诊断效率。结果:在骨髓(SUVmax中值，5.10)、脾脏(SUVmax中值，3.70)和淋巴结(LNs, SUVmax中值，5.55)中观察到高18F-FDG蓄积。骨髓SUVmax (rho = 0.376, p = 0.004)、脾脏SUVmax (rho = 0.450, p total of LNs (rho = 0.386, p = 0.017)、MLVtotal of LNs (rho = 0.391, p = 0.015)与系统评分相关。MAS组脾SUVmax (p = 0.017)、TLGtotal of LNs (p = 0.045)、MLVtotal of LNs (p = 0.012)均高于无MAS组。MLVtotal > 62.2 (OR 27.375, p = 0.042)是MAS的独立预测因素，敏感性为80.0%，特异性为93.9%。结论:脾脏糖代谢水平可作为疾病严重程度的有效且简便的影像学指标，MLVtotal≥62.2是AOSD患者发生MAS的有力预测指标。

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来源期刊

Arthritis Research & Therapy RHEUMATOLOGY-

CiteScore

8.30

自引率

2.00%

发文量

261

审稿时长

2.3 months

期刊介绍： Established in 1999, Arthritis Research and Therapy is an international, open access, peer-reviewed journal, publishing original articles in the area of musculoskeletal research and therapy as well as, reviews, commentaries and reports. A major focus of the journal is on the immunologic processes leading to inflammation, damage and repair as they relate to autoimmune rheumatic and musculoskeletal conditions, and which inform the translation of this knowledge into advances in clinical care. Original basic, translational and clinical research is considered for publication along with results of early and late phase therapeutic trials, especially as they pertain to the underpinning science that informs clinical observations in interventional studies.