Bindoli Sara, Galozzi Paola, Magnani Fabio, Rubin Laura, Campi Cristina, Doria Andrea, Cecchin Diego, Sfriso Paolo
Rheumatology Unit, Department of Medicine, Padova University Hospital, Padova, Italy.
Nuclear Medicine Unit, Department of Medicine, Padova University Hospital, Padova, Italy.
Front Med (Lausanne). 2020 Oct 22;7:544412. doi: 10.3389/fmed.2020.544412. eCollection 2020.
The objective of the study was to assess the advantages of F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography with magnetic resonance (PET/CT-MR) in diagnosing and monitoring patients with adult-onset Still's disease (AOSD). Participants in this retrospective case-control study underwent whole-body F-FDG-PET/CT-MR imaging. All PET scans were qualitatively and semiquantitatively analyzed using standardized uptake values (SUVs) normalized to liver uptake, i.e., we calculated the ratio (SUVr) between the minimum, maximum, and mean SUVs for different organs and tissues and the mean SUV for the liver. Disease activity scores were assessed using Pouchot's criteria. Eighteen patients diagnosed with AOSD and 24 controls (non-AOSD patients diagnosed with solid tumors, excluding lymphomas) were considered. A total of 38 PET/MR and nine PET/CT scans were analyzed. AOSD patients had higher SUVr than controls. All SUVr differed significantly between the patient and control group for bone marrow, and for the spleen, the only difference lacking statistical significance concerned the ratio of the minimum SUV for spleen to the mean SUV for liver. Though limited in number, AOSD responders to therapy showed lower uptakes during the period monitored. No correlations were found between Pouchot's scores and SUVr. Our data revealed higher spleen and bone marrow F-FDG uptakes on PET/CT and PET/MR images in AOSD patients than in controls. Together with clinical examinations and laboratory data, PET/CT and PET/MR seemed more reliable than Pouchot's score in assessing disease activity.
本研究的目的是评估氟脱氧葡萄糖（FDG）正电子发射断层扫描与磁共振计算机断层扫描（PET/CT-MR）在诊断和监测成人斯蒂尔病（AOSD）患者中的优势。这项回顾性病例对照研究的参与者接受了全身F-FDG-PET/CT-MR成像。所有PET扫描均使用标准化摄取值（SUV）进行定性和半定量分析，标准化摄取值以肝脏摄取为参照进行归一化，即我们计算了不同器官和组织的最小、最大和平均SUV与肝脏平均SUV之间的比值（SUVr）。使用Pouchot标准评估疾病活动评分。研究纳入了18例诊断为AOSD的患者和24例对照（诊断为实体瘤的非AOSD患者，不包括淋巴瘤）。共分析了38次PET/MR和9次PET/CT扫描。AOSD患者的SUVr高于对照组。患者组和对照组在骨髓的所有SUVr均有显著差异，而在脾脏方面，唯一缺乏统计学意义的差异是脾脏最小SUV与肝脏平均SUV的比值。尽管数量有限，但接受治疗的AOSD缓解者在监测期间显示出较低的摄取。未发现Pouchot评分与SUVr之间存在相关性。我们的数据显示，AOSD患者PET/CT和PET/MR图像上脾脏和骨髓的F-FDG摄取高于对照组。与临床检查和实验室数据一起，PET/CT和PET/MR在评估疾病活动方面似乎比Pouchot评分更可靠。
