Department of Clinical Immunology, Xijing Hospital, The Fourth Military Medical University; Department of Cell Biology, Fourth Military Medical University; National Translational Science Center for Molecular Medicine, Xi'an, Shaanxi Province, China.
Department of Cell Biology, Fourth Military Medical University; National Translational Science Center for Molecular Medicine, Xi'an, Shaanxi Province, China.
Clin Exp Rheumatol. 2018 Mar-Apr;36 Suppl 111(2):88-92. Epub 2018 Feb 7.
The commonly adopted method of defining active disease in Takayasu's arteritis (TAK) is the definition used by the US National Institutes of Health (NIH). A gold standard in imaging techniques for assessing disease activity in TAK has not been clearly established and the creation of practical and valid tools represents a challenge. To assess whether 18F-FDG-PET/CT and NIH criteria show a good level of agreement in assessing disease activity of TAK patients.
18F-FDG-PET/CT was performed in 17 patients with TAK. All 17 patients fulfilled the clinical criteria according to the American College of Rheumatology criteria. Two nuclear physicians visually assessed the degree of 18F-FDG uptake in the inflammatory vascular lesion. 18F-FDG-PET/CT and the inflammatory vascular lesion were evaluated by using the standardised uptake value (SUV) of 18F-FDG accumulation were interpreted as active vasculitic lesions.
Of the 17 patients, 6 were in the active stage and 11 were in the inactive stage according to the level of disease activity as clinically assessed by the NIH criteria. No significant 18F-FDG accumulation was observed in the patients with inactive disease (SUV≤1.2). 18F-FDG-PET/CT localised 18F-FDG accumulation in the inflammatory lesion in the patients with TAK who had inactive disease (n=3) assessed by the NIH criteria. 18F-FDG PET/CT revealed intense 18F-FDG accumulation (SUV max 2.88) in the vasculature of 3 patients in the inactive stage of TAK. The other 8 patients in the active stage showed weak 18F-FDG accumulation (SUV ≤1.2).
18FDG-PET/CT appears to be a promising technique for the diagnosis and assessment of disease activity in patients of TAK, even those considered to be inactive by the NIH criteria. However, it needs to be validated in larger groups for cost-effectiveness and sensitivity to change.
大动脉炎（TAK）活动期的常用定义方法是美国国立卫生研究院（NIH）采用的定义。尚未明确建立评估 TAK 疾病活动的影像学技术的金标准，因此创建实用且有效的工具是一项挑战。评估 18F-FDG-PET/CT 和 NIH 标准在评估 TAK 患者疾病活动中的一致性程度。
对 17 例 TAK 患者进行 18F-FDG-PET/CT 检查。所有 17 例患者均符合美国风湿病学会标准的临床标准。两名核医学医师对炎症性血管病变中 18F-FDG 摄取程度进行了视觉评估。18F-FDG-PET/CT 和炎症性血管病变的评估采用 18F-FDG 摄取的标准化摄取值（SUV）进行，SUV≥2.5 被认为是活动性血管炎病变。
根据 NIH 标准评估的疾病活动水平，17 例患者中 6 例为活动期，11 例为静止期。无活动期疾病（SUV≤1.2）患者未见明显 18F-FDG 聚集。NIH 标准评估为无活动期的 TAK 患者（n=3），18F-FDG-PET/CT 显示炎症性病变存在 18F-FDG 聚集。3 例 TAK 静止期患者血管内出现强烈的 18F-FDG 聚集（SUV max 2.88）。8 例活动期患者显示较弱的 18F-FDG 聚集（SUV≤1.2）。
18F-FDG-PET/CT 似乎是一种很有前途的技术，可用于诊断和评估 TAK 患者的疾病活动，即使是 NIH 标准认为无活动期的患者也是如此。然而，它需要在更大的人群中进行验证，以评估其成本效益和对变化的敏感性。
