Radiographic features of 18F-FDG PET/CT in the assessment of disease activity in adult-onset Still′s disease / 中华核医学与分子影像杂志

ABSTRACT

Objective:To investigate the characteristic findings of 18F-fluorodeoxyglucose (FDG) PET/CT in patients with adult-onset Still′s disease (AOSD) and the correlation between the maximum standardized uptake value (SUV max) and clinical disease activity score as well as laboratory data. Methods:Twenty-two patients (6 males, 16 females, age range 19-73 (41.5±16.3) years) with AOSD according to criteria set by Yamaguchi between May 2015 and June 2018 in Nanjing Drum Tower Hospital were recruited in the retrospective study. The characteristic findings of 18F-FDG PET/CT in the consecutive AOSD patients were evaluated. The correlation between SUV max and clinical disease activity score as well as laboratory data was assessed with Spearman rank correlation analysis. Results:PET/CT results contributed to the diagnosis of AOSD in all the 22 patients (100%). The accumulation of 18F-FDG was showed in lymph nodes of 21 patients(95.5%), and the spleen and bone marrow uptake were observed in all the 22 patients (100%). Besides, 18F-FDG uptake was found in shoulder joint ( n=6, 27.3%), submaxillary glands ( n=9, 40.9%) and parotid glands ( n=7, 31.8%). The SUV max of lymph nodes were significantly correlated with the C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) ( r s values 0.622, 0.538, both P<0.05). The SUV max of spleen was significantly correlated with CRP and ESR levels ( r s values 0.543, 0.475, both P<0.05). The SUV max of bone marrow was significantly correlated with the level of CRP and neutrophils(%) ( r s values 0.497, 0.431, both P<0.05). However, there was no correlation between the SUV max and clinical disease activity score ( r s values 0.008, 0.102, 0.210, all P>0.05). Conclusions:Characteristics findings of 18F-FDG PET/CT imaging can provide useful information for differential diagnosis as well as extent assessment for AOSD, and play an important role in the diagnosis process of AOSD. 18F-FDG PET/CT scan may be a helpful imaging technique for evaluation of disease activity in patients with AOSD but prospective study with large cohort of individuals are needed.