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Clin Rheumatol. 2015 Dec;34(12):2047-56. doi: 10.1007/s10067-015-2901-6. Epub 2015 Feb 26.

18F-FDG PET/CT in patients with adult-onset Still's disease.

Author information

1
PET Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, People's Republic of China.
2
Key Laboratory of Reproductive Genetics (Zhejiang University), Ministry of Education, Women's Reproductive Health Key Laboratory of Zhejiang Province, Zhejiang, 310003, People's Republic of China.
3
PET Center, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, People's Republic of China. dmjlzfwgl@126.com.
4
Rheumatology Department, The First Affiliated Hospital, College of Medicine, Zhejiang University, Zhejiang, 310003, People's Republic of China.

Abstract

(18)F-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) has become useful for the detection and diagnosis of inflammatory conditions, including rheumatic diseases, immunoglobulin (Ig) G4-related disease and giant cell arteritis. However, few articles based on small sample sizes (n = 7) diagnosed as adult-onset Still's disease (AOSD) have been published. The study aim was to observe the reliable characteristics and usefulness of (18)F-FDG PET/CT for the evaluation of consecutive patients with AOSD. Eligible patients were selected from among those who had undergone (18)F-FDG PET/CT between May 2007 and June 2014. Twenty-six consecutive AOSD patients were recruited retrospectively according to criteria set by Yamaguchi et al. All patients underwent evaluation by (18)F-FDG PET/CT. The characteristics and usefulness of (18)F-FDG PET/CT for evaluation of consecutive patients with AOSD were evaluated. All 26 patients had (18)F-FDG-avid lesion(s) related to their particular disease. Diffuse and homogeneous accumulation of (18)F-FDG was seen in the bone marrow (26/26; 100 %; maximum standardized uptake (SUVmax), 2.10-6.73) and spleen (25/26; 96.15 %). The SUVmax of affected lymph nodes was 1.3-9.53 (mean ± SD, 4.12 ± 2.24). The SUVmax and size factors (maximum diameter and areas) of affected lymph nodes were significantly different (P = 0.033 and P = 0.012, respectively). (18)F-FDG PET/CT showed the general distribution of (18)F-FDG accumulation. This factor helped to exclude malignant disease and aided the diagnosis of AOSD (42.3 %) in 11 cases when combined with clinical features and aided decisions regarding appropriate biopsy sites, such as the lymph nodes (n = 9) and bone marrow (n = 13). (18)F-FDG PET/CT is a unique imaging method for the assessment of metabolic activity throughout the body in subjects with AOSD. Characteristics or patterns of AOSD observed on (18)F-FDG PET/CT can be used for the indication and diagnosis or to guide the clinical management of ASOD.

KEYWORDS:

18F-FDG PET/CT; Adult-onset Still’s disease; Bone marrow; Diagnosis; Lymph nodes

PMID:
25711875
DOI:
10.1007/s10067-015-2901-6
[Indexed for MEDLINE]

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