Title: The impact of F-18-FDG PET on the management of patients with suspected large vessel vasculitis
Authors: Fuchs, Martin ×
Briel, Matthias
Daikeler, Thomas
Walker, Ulrich A
Rasch, Helmut
Berg, Scott
Ng, Quinn K. T
Raatz, Heike
Jayne, David
Koetter, Ina
Blockmans, Daniel Engelbert
Cid, Maria C
Prieto-Gonzalez, Sergio
Lamprecht, Peter
Salvarani, Carlo
Karageorgaki, Zaharenia
Watts, Richard
Luqmani, Raashid
Mueller-Brand, Jan
Tyndall, Alan
Walter, Martin A #
Issue Date: Feb-2012
Series Title: European Journal of Nuclear Medicine and Molecular Imaging vol:39 issue:2 pages:344-353
Abstract: PURPOSE: We aimed to assess the impact of (18)F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis.
METHODS: An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of (18)F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the (18)F-FDG PET results were compared using logistic regression models.
RESULTS: The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. (18)F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1-87.7%], a specificity of 83.9% (95% CI 66.3-94.5%), a positive predictive value of 81.5% (95% CI 61.9-93.7%) and a negative predictive value of 76.5% (95% CI 58.8-89.3%). The diagnostic accuracy of (18)F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of (18)F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of (18)F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication.
CONCLUSION: (18)F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients.
ISSN: 1619-7070
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory for Clinical Infectious and Inflammatory Disorders
Department of Microbiology & Immunology - miscellaneous
× corresponding author
# (joint) last author

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