¹⁸F-FDG PET and PET/CT examination in patients with giant cell arteritis – a practical view from a PET center

Česká verzia

Authors: Z. Řehák ^1,2; Z. Fojtík ³; L. Fryšáková ⁴; J. Šimíková ⁵; I. Kielkowská ⁶; P. Němec ⁷; E. Eberová ⁸; Obrovská M Křivanová ³; J. Staníček ¹; J. Eremiášová ¹; J. Vašina ¹; D. Řeháková ⁹; M. Šnelerová ¹⁰; T. Tichý ¹¹; L. Křen ¹²
Authors place of work: Oddělení nukleární medicíny, centrum PET, Masarykův onkologický ústav Brno ¹; Regionální centrum aplikované molekulární onkologie Masarykův onkologický ústav Brno, LF MU Brno ²; Interní hematologická a onkologická klinika FN a LF MU Brno ³; III. interní klinika FN a LF UP Olomouc ⁴; Interní oddělení, revmatologická ambulance, nemocnice Kyjov ⁵; Interní klinika FN Ostrava ⁶; II. interní klinika FN u sv. Anny v Brně a LF MU Brno ⁷; Revmatologická poradna, nemocnice s poliklinikou Karviná-Ráj ⁸; Klinika interní, geriatrie a praktického lékařství FN a LF MU Brno ⁹; Klinika infekčních chorob FN a LF MU Brno ¹⁰; Ústav patologie FN a LF UP Olomouc ¹¹; Ústav patologie FN a LF MU Brno ¹²
Published in the journal: Čes. Revmatol., 22, 2014, No. 2, p. 91-98.
Category: Review Article

Summary

Giant cell arteritis (GCA) is a systemic vasculitis of large arteries, which affects older people, more frequently women. Febrile illness with elevation of nonspecific laboratory markers of inflammation (ESR, CRP) may be the first symptom of this disease. In such a condition an FDG PET (PET/CT) examination can be performed due to a wider differential diagnosis. Findings of high FDG uptake in the aorta and large arteries, especially those originating from the aortic arch, are relatively uniform and typical of GCA, even at a stage when structural changes of the arteries have not developed yet. Involvement of temporal artery can be visualized using hybrid PET/CT scanners, yet rather in isolated cases. FDG uptake in the walls of large arteries can be also used to assess the disease activity (both remission and possible relapse), furthermore, this finding correlates with laboratory evidence of disease activity (ESR, CRP). Although PET (PET/CT) examination is frequently used for primary diagnosis and monitoring of disease activity, these examinations are not considered standard. Herein, we present 4 patients using visual documentation. In these patients, PET (PET/CT) examination was used for primary diagnosis, and is compared with the CT angiography or MR angiography. In 2 patients, histological verification is presented. In 3 out of 4 patients, further course of the disease was monitored by PET examination as well.

Key words:
Giant cell arteritis, temporal arteritis, large vessel vasculitis, PET, PET/CT

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