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Inflamm Bowel Dis. 2016 Nov;22(11):2619-2629.

Role of 18F-fluorodeoxyglucose Positron Emission Tomography in the Monitoring of Inflammatory Activity in Crohn's Disease.

Author information

1
*Division of Experimental Medicine, Department of Medicine, Imperial College London, London, United Kingdom; Departments of †Gastroenterology and ‡Imaging, Imperial College Healthcare NHS Trust, London, United Kingdom; §Imanova Centre for Imaging Sciences, London, United Kingdom; ‖Centre for Neuroimaging Sciences, King's College, London, United Kingdom; ¶Centre for Medical Imaging, University College London, London, United Kingdom; **Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom; and ††Division of Hepatology and Gastroenterology, Department of Surgery and Cancer, Imperial College Healthcare NHS Trust, London, United Kingdom.

Abstract

BACKGROUND:

Fluorine-fluorodeoxyglucose positron emission tomography (F-FDG PET) has recently attracted interest for the measurement of disease activity in Crohn's disease (CD). The aim of this study was to assess the utility of FDG-PET as a marker of progression of inflammatory activity and its response to treatment in patients with CD.

METHODS:

Twenty-two patients with active CD were recruited prospectively to undergo FDG-PET scanning at 2 time points. All 22 index scans were used to assess sensitivity and specificity against a reference standard magnetic resonance imaging measure. Correlations with clinicopathological markers of severity (Harvey-Bradshaw Index, C-reactive protein, and calprotectin) were also performed. Of note, 17/22 patients participated in the longitudinal component and underwent scanning before and 12 weeks after the initiation of anti-tumor necrosis factor alpha therapy. Patients were subcategorized on the basis of a clinically significant response, and responsiveness of the PET measures was assessed using previously described indices. Of note, 5/22 patients took part in the test-retest component of the study and underwent scanning twice within a target interval of 1 week, to assess the reproducibility of the PET measures.

RESULTS:

The sensitivity and specificity of F-FDG PET were 88% and 70%, respectively. Standardized uptake value (SUV)-related PET measures correlated significantly both with C-reactive protein and Harvey-Bradshaw Index in cross-sectional and longitudinal analyses. (G)SUVMAX and (G)SUVMEAN demonstrated favorable responsiveness and reliability characteristics (responsiveness ratio of Guyatt >0.80 and % variability <20%) compared with volume-dependent FDG-PET measures. A proportion of the FDG signal (10%-30%) was found to originate from the lumen of diseased segments.

CONCLUSIONS:

F-FDG PET may be useful for longitudinal monitoring of inflammatory activity in CD.

PMID:
27753695
DOI:
10.1097/MIB.0000000000000924
[Indexed for MEDLINE]

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