Preliminary Application of18F-FDG PET/CT in Rheumatic Diseases / 中国医学影像学杂志

ABSTRACT

PurposeCurrent conventional imaging methods X-ray, CT, MRI and ultrasound for rheumatic diseases are mostly local site imaging, rather than systemic display, thus is difficult to show the whole picture of the diseases, this study aims to explore the18F-FDG PET/CT findings of rheumatic diseases and its preliminary clinical value. Materials and Methods18F-FDG PET/CT imaging findings and clinical data of 18 patients with rheumatic diseases confirmed by clinical diagnosis were retrospectively analyzed, and 18F-FDG uptake of lesions was observed.Results Among all the 18 patients with rheumatic diseases four cases were with rheumatoid arthritis (RA), 5 cases with takayasu arteritis (TA), 2 cases with adult onset Still’s disease (AOSD), 1 case with polymyalgia rheumatica (PMR) and 6 cases with ankylosing spondylitis (AS). Findings of PET/CT RA showed increased FDG uptake in multiple bigger joints such as shoulder joint, elbow, hip, wrist joint, and part palm finger joints, with no bone abnormalities in CT; TA displayed as diffusely increased uptake of FDG the aorta and its major branches vascular wall while CT showed multiple arterial wall irregular thickening with dot or strip calcification, and in one case, the vascular wall FDG uptake decreased obviously after one year treatment, the SUVmax of left clavicle dropped from 6.8 to 3.2; AOSD showed diffusely increased FDG uptake in spleen and bone marrow, while CT had no obvious spleen and bone abnormalities; PMR showed increased uptake of FDG in the atlantoaxial joint, shoulder joint, sternoclavicular joint, hip joint, pubic symphysis, ischial tuberosity and lesions around lumbar spinous process; only 1 case of 6 AS patients showed left acetabular articular surface hyperplasia and sclerosis with increased FDG uptake, while CT showed spinal multiple vertebral bone hyperplasia and sclerosis as bamboo change in all of 6 AS cases, with normal FDG metabolism. Conclusion18F-FDG PET/CT is helpful for the diagnosis of rheumatic diseases, because it can be used to display the lesion extent, reflect its activity, and also to evaluate the effect of the treatments.