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REVIEW  PET/CT IMAGING IN AUTOIMMUNE DISORDERS Free accessfree

The Quarterly Journal of Nuclear Medicine and Molecular Imaging 2022 September;66(3):182-93

DOI: 10.23736/S1824-4785.22.03465-3

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

The role of PET/CT in large vessel vasculitis and related disorders: diagnosis, extent evaluation and assessment of therapy response

François JAMAR 1 , Lars C. GORMSEN 2, Halil YILDIZ 3, Riemer H. SLART 4, 5, Kornelis S. van der GEEST 6, Olivier GHEYSENS 1

1 Department of Nuclear Medicine, Saint-Luc University Clinics and Institute of Clinical and Experimental Research (IREC), Catholic University of Louvain (UCLouvain), Brussels, Belgium; 2 Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark; 3 Department of Internal Medicine and Infectious Diseases, Saint-Luc University Clinics, Brussels, Belgium; 4 Department of Nuclear Medicine and Molecular Imaging, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands; 5 Department of Biomedical Photonic Imaging, Faculty of Science and Technology, University of Twente, Enschede, the Netherlands; 6 Department of Rheumatology and Clinical Immunology, University Medical Center of Groningen, University of Groningen, Groningen, the Netherlands



Large vessel vasculitides (LVV) are defined as chronic inflammatory disorders that affect the arteries with two major variants being distinguished: giant cell arteritis (GCA) and Takayasu’s arteritis (TAK). These often present with nonspecific constitutional symptoms which makes an accurate diagnosis often challenging. Nevertheless, timely diagnosis is of utmost importance to initiate treatment and to avoid potential life-threatening complications. [18F]FDG-PET/CT is nowadays widely accepted as useful tool to aid in the diagnosis of large vessel vasculitis. However, its role to monitor disease activity and to predict disease relapse during follow-up is less obvious since vascular [18F]FDG uptake can be detected in the absence of clinical or biochemical signs of disease activity. In addition to the two major variants, [18F]FDG-PET/CT has shown promise in (peri-)aortitis and related disorders. This article aims to provide an update on the current knowledge and limitations of [18F]FDG-PET/CT for the diagnosis and assessment of treatment response in LVV. Furthermore, other radiopharmaceuticals targeting key components of the vascular immune system are being discussed which could provide an interesting alternative to image vascular inflammation in LVV.


KEY WORDS: Positron emission tomography computed tomography; Fluorodeoxyglucose F18; Vasculitis; Aortitis

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