Value of 18F-FDG PET/CT in evaluating the activity of Takayasu arteritis / 中华核医学与分子影像杂志

ABSTRACT

Objective:To investigate the value of 18F-FDG PET/CT in qualitative evaluation of disease activity in patients with Takayasu arteritis (TA), and discuss the relationship between PET vascular activity score (PETVAS) and disease activity. Methods:A total of 84 patients (12 males, 72 females, age (30.0±7.3) years) with TA, who underwent 18F-FDG PET/CT imaging in the First Affiliated Hospital of Zhengzhou University between February 2016 and August 2021, were retrospectively reviewed. All patients were divided into active ( n=68) and inactive groups ( n=16) according to Kerr score. PET/CT images were semiquantitatively evaluated according to the visual score and PETVAS was calculated. Mann-Whitney U test was used to compare the differences of PETVAS and inflammatory indexes (erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP)) between two groups. Spearman rank correlation analysis was used to evaluate the relationships among PETVAS, Kerr score and inflammatory indexes. ROC curve analysis was employed to compare the diagnostic efficiencies of PETVAS, ESR and CRP for disease activity. Results:The sensitivity, specificity and accuracy of 18F-FDG PET/CT in evaluating the activity of TA by visual score (≥2) were 86.8%(59/68), 15/16 and 88.1%(74/84), respectively. PETVAS, ESR(mm/1 h) and CRP(mg/L) in active group were higher than those in inactive group (11.0 (6.0, 18.0) vs 0.0 (0.0, 3.0), 67.0 (25.3, 104.0) vs 10.1 (7.1, 20.8) and 32.3 (7.1, 72.1) vs 1.8 (1.0, 5.3), respectively; z values 4.53-5.23, all P<0.001). PETVAS was positively correlated with Kerr score ( rs=0.65, P<0.001), ESR ( rs=0.57, P<0.001) and CRP ( rs=0.56, P<0.001). The correlation coefficient between Kerr score and PETVAS was higher than that between Kerr score and CRP ( rs=0.55, P<0.001) and ESR ( rs=0.55, P<0.001). ROC AUC and Youden Index (YI) of PETVAS (AUC=0.92, YI=0.77) were higher than those of CRP (AUC=0.87, YI=0.65) and ESR ( AUC=0.87, YI=0.66). Conclusions:18F-FDG PET/CT is an effective tool for qualitative evaluation of TA disease activity. PETVAS is helpful in evaluating disease activity of TA, with a better efficacy than inflammatory indexes.