Cranial and large vessel activity on positron emission tomography scan at diagnosis and 6 months in giant cell arteritis

Anthony M. Sammel*, Edward Hsiao, Geoffrey Schembri, Elizabeth Bailey, Katherine Nguyen, Janice Brewer, Leslie Schrieber, Beatrice Janssen, Peter Youssef, Clare L. Fraser, Rodger Laurent

*Corresponding author for this work

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)582-588
Number of pages7
JournalInternational Journal of Rheumatic Diseases
Volume23
Issue number4
DOIs
Publication statusPublished - 1 Apr 2020
Externally publishedYes

Keywords

  • giant cell arteritis
  • positron emission tomography
  • prognosis
  • systemic vasculitis

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