Vicente Aldasoro, Vicky Betech-Antar, Santos Castañeda, Eugenio de Miguel, Juan José Rosales, María José García-Velloso
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Baseline PET was positive in all but one: 18 patients at 60 min and 7 patients after delayed imaging at 180 min. The median (IQR) GC dose at the time of baseline PET was 45 mg/d (26.2-45) of prednisone equivalent with a median exposure of 14 days (7-76.2). At 6 months of follow-up, PET was performed in 22 patients, with positive results in 16. Delayed imaging was performed in 6 patients due to negative PET at 60 min, with positive results in all cases, despite treatment with GC and/or biological therapy.</p><p><strong>Conclusions: </strong>In patients on GC therapy, delayed imaging protocols applying procedural recommendations for vascular quantification could improve diagnostic accuracy. Therefore, we suggest performing imaging only at 180 min in patients who have been on GCs for more than 3 days as well as in those with highly suspected GCA but negative findings in baseline PET at 60 min.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":null,"pages":null},"PeriodicalIF":3.4000,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Diagnosis of giant cell arteritis by 18F-FDG PET/CT in patients on glucocorticoid therapy: importance of delayed imaging.\",\"authors\":\"Vicente Aldasoro, Vicky Betech-Antar, Santos Castañeda, Eugenio de Miguel, Juan José Rosales, María José García-Velloso\",\"doi\":\"10.55563/clinexprheumatol/db8p4e\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>The aim of this study is to analyse the diagnostic value of positron emission tomography (PET) in patients with giant cell arteritis (GCA) despite glucocorticoid (GC) therapy before PET acquisition.</p><p><strong>Methods: </strong>Consecutive patients with strongly suspected GCA according to 2022 EULAR/ACR criteria were included. 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引用次数: 0
摘要
研究目的本研究旨在分析正电子发射断层扫描(PET)在巨细胞动脉炎(GCA)患者中的诊断价值,这些患者在 PET 采集前曾接受过糖皮质激素(GC)治疗:方法:根据 2022 年 EULAR/ACR 标准,连续纳入强烈怀疑为 GCA 的患者。随访6个月后医生诊断为GCA是金标准。在基线和6个月后进行PET检查。对于 60 分钟后结果为阴性的患者,则在 180 分钟后进行延迟成像:共纳入 26 名患者,中位(IQR)年龄为 70.5(57-88)岁。除一名患者外,其他患者的基线 PET 均为阳性:其中 18 名患者在 60 分钟时 PET 呈阳性,7 名患者在 180 分钟延迟成像后 PET 呈阳性。基线 PET 时的 GC 剂量中位数(IQR)为 45 毫克/天(26.2-45)泼尼松当量,中位暴露时间为 14 天(7-76.2)。随访 6 个月时,对 22 名患者进行了 PET 检测,其中 16 人检测结果呈阳性。6名患者因60分钟后PET呈阴性而进行了延迟成像,尽管接受了GC和/或生物治疗,但所有病例的结果均为阳性:结论:对于接受 GC 治疗的患者,延迟成像方案应用血管定量的程序建议可提高诊断准确性。因此,我们建议对服用 GC 超过 3 天的患者以及高度怀疑 GCA 但在 60 分钟时基线 PET 结果为阴性的患者仅在 180 分钟时进行成像。
Diagnosis of giant cell arteritis by 18F-FDG PET/CT in patients on glucocorticoid therapy: importance of delayed imaging.
Objectives: The aim of this study is to analyse the diagnostic value of positron emission tomography (PET) in patients with giant cell arteritis (GCA) despite glucocorticoid (GC) therapy before PET acquisition.
Methods: Consecutive patients with strongly suspected GCA according to 2022 EULAR/ACR criteria were included. The physician diagnosis of GCA after 6 months of follow-up was the gold standard. PET was performed at baseline and 6 months later. In patients with negative results at 60 min, delayed imaging was performed at 180 min.
Results: Twenty-six patients were included with a median (IQR) age of 70.5 (57-88) years. Baseline PET was positive in all but one: 18 patients at 60 min and 7 patients after delayed imaging at 180 min. The median (IQR) GC dose at the time of baseline PET was 45 mg/d (26.2-45) of prednisone equivalent with a median exposure of 14 days (7-76.2). At 6 months of follow-up, PET was performed in 22 patients, with positive results in 16. Delayed imaging was performed in 6 patients due to negative PET at 60 min, with positive results in all cases, despite treatment with GC and/or biological therapy.
Conclusions: In patients on GC therapy, delayed imaging protocols applying procedural recommendations for vascular quantification could improve diagnostic accuracy. Therefore, we suggest performing imaging only at 180 min in patients who have been on GCs for more than 3 days as well as in those with highly suspected GCA but negative findings in baseline PET at 60 min.
期刊介绍:
Clinical and Experimental Rheumatology is a bi-monthly international peer-reviewed journal which has been covering all clinical, experimental and translational aspects of musculoskeletal, arthritic and connective tissue diseases since 1983.