Cranial and large vessel activity on positron emission tomog
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Positron emission tomography/computer tomography (PET/CT) scan can be used to diagnose and assess disease activity in patients with giant cell arteritis (GCA). Vasculitis is detected by increased uptake of radioactive glucose‐labeled tracer fluorine‐18‐fluoro‐2‐deoxyglucose (FDG) in arterial walls compared with background blood pool or the liver.3 Recently, our group demonstrated that time‐of‐flight (TOF) PET/CT can detect vasculitis in both cranial and large vessels and offers high sensitivity (92%) and specificity (85%) for diagnosing GCA.

21 GCA patients and 15 underwent a serial scan. Twelve patients experienced a relapse and 5 of these had ischemic features of vision disturbance, jaw or limb claudication. Five out of 15 patients had persistent uptake in at least 1 vessel on the serial PET/CT but none experienced a subsequent relapse.

In summary, this study confirms that PET/CT‐detected vasculitis activity for both cranial and large vessels reduces between diagnosis and 6 months. None of the patients with persistent vascular activity at 6‐month scans experienced subsequent clinical relapse. Larger studies are needed to confirm the prognostic significance of a high vascular score at diagnosis and confirm our numerical finding that patients with TVS ≥10 may be at increased risk of ischemic relapse.

Source: https://onlinelibrary.wiley.com/doi/10.1111/1756-185X.13805
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