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18F-fluorodeoxyglucose positron emission tomography-computed tomography findings of polymyalgia rheumatica in patients with giant cell arteritis

Abstract: Objective: Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are often overlapping conditions. We studied whether 18F-fluorodeoxyglucose (FDG) positron emission tomography-computed tomography (PET-CT) is useful in identifying PMR in the setting of large vessel (LV) GCA. Methods: LV-GCA patients diagnosed by PET-CT at a tertiary care center for a population of 450,000 people over a two-year period were reviewed. Scoring was performed based on potential significant FDG uptake at up to 16 sites in nine different extravascular areas (SCORE 16). Differences in extravascular sites of significant FDG uptake were evaluated between LV-GCA with a clinical diagnosis of PMR or not. Results: Fifty-four patients were diagnosed with LV-GCA by 18F-FDG-PET-CT. Of them, 21 (38.8%) were clinically diagnosed with PMR. Significant extravascular FDG uptake was more frequently observed in those with a clinical diagnosis of PMR. In this sense, the SCORE 16 was higher in those with clinical PMR (5.10 ± 4.05 versus 1.73 ± 2.31 in those without a clinical diagnosis of PMR; p < 0.001). A SCORE 16 involving more than four sites of significant FDG uptake yielded a sensitivity of 52% and a specificity of 91% for establishing a clinical diagnosis of PMR associated with LV-GCA. The best areas of significant FDG uptake to clinically identify PMR in patients with LV-GCA were the shoulder, the greater trochanter, and the lumbar interspinous regions, with an area under the ROC curve of 0.810 (0.691-0.930). Conclusions: Significant extravascular 18F-FDG-PET-CT uptake may help establish a clinical diagnosis of PMR in patients with LV-GCA. These patients are more commonly diagnosed with PMR if they have significant FDG uptake in the shoulder, greater trochanter, and lumbar interspinous areas.

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Autoría: Heras-Recuero E., Martínez de Bourio-Allona M., Landaeta-Kancev L.C., Blázquez-Sánchez T., Torres-Roselló A., Álvarez-Rubio M., Belhaj-Gandar M., Martínez-López J.A., Martínez-Dhier L., Llorca J., Largo R., González-Gay M.Á.,

 Fuente: Journal of Clinical Medicine, 2023, 12, 6983

Editorial: MDPI

 Año de publicación: 2023

Nº de páginas: 12

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/jcm12226983

ISSN: 2077-0383

Autoría

HERAS-RECUERO, ELENA

MARTÍNEZ DE BOURIO-ALLONA, MARTA

LANDAETA-KANCEV, LAURA CRISTINA

BLÁZQUEZ-SÁNCHEZ, TERESA

TORRES-ROSELLÓ, ARANTXA

ÁLVAREZ-RUBIO, MIGUEL

BELHAJ-GANDAR, MARIAM

MARTÍNEZ-LÓPEZ, JUAN ANTONIO

MARTÍNEZ-DHIER, LUIS

FRANCISCO JAVIER LLORCA DIAZ