Format

Send to

Choose Destination
Eur J Nucl Med Mol Imaging. 2017 Dec;44(13):2274-2279. doi: 10.1007/s00259-017-3774-5. Epub 2017 Jul 24.

Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement.

Author information

1
Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France. deboysson-h@chu-caen.fr.
2
Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France.
3
Department of Internal Medicine, Limoges University Hospital, Limoges, France.
4
Department of Internal Medicine, Lille University Hospital, Lille, France.
5
Department of Nuclear Medicine, Caen University Hospital, Caen, France.
6
INSERM U1086 "ANTICIPE", François Baclesse Cancer Centre, Caen, France.
7
Normandy University, EA4650, Caen, France.

Abstract

PURPOSE:

The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA).

METHODS:

We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen's kappa concordance index.

RESULTS:

We included 28 patients (21/7 women/men, median age 67 [56-82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1-7] and 3 [1-6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64-1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54-0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively.

CONCLUSIONS:

CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta's branches.

KEYWORDS:

18FDG-pet/Ct; CT angiography; Giant-cell arteritis; Large-vessel vasculitis

PMID:
28736805
DOI:
10.1007/s00259-017-3774-5
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center