Kothekar Esha, Revheim Mona-Elisabeth, Borja Austin J, Hancin Emily C, Detchou Donald K, Werner Thomas J, Shin Daniel B, Gelfand Joel M, Alavi Abass
Department of Radiology, Hospital of The University of Pennsylvania Philadelphia, PA, USA.
Division of Radiology and Nuclear Medicine, Oslo University Hospital Norway.
Am J Nucl Med Mol Imaging. 2020 Oct 15;10(5):265-271. eCollection 2020.
Psoriatic skin lesions are metabolically active, which makes them candidates for imaging with 18-F fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT). The aim of our study was to correlate FDG-PET findings with Psoriasis Area and Severity Index (PASI) scores, the most widely-used grading system for psoriasis. Thirty-three subjects and a total of 84 FDG-PET/CT scans from a prospective clinical trial [NCT01553058] with >2 months moderate-to-severe psoriasis were included. Subjects underwent whole-body FDG-PET/CT imaging 60 min after intravenous FDG administration, prior to the start of treatment. Scans were repeated 12 weeks and 52 weeks after baseline scans were conducted and after treatment or placebo administration was initiated. Each subject and scan was graded by our "PET-PASI" scoring system, a qualitative review of multi-plane reconstructions for both attenuation-corrected (AC) and non-attenuation-corrected (NAC) PET images. PASI and PET-PASI scores were correlated using Spearman's rho analysis. Our study demonstrated a significant positive correlation between each subject's corresponding PET-PASI and PASI scores before and during treatment or placebo administration (r=0.53, P<0.001). We also found positive correlations between PET-PASI and PASI scores across different regions of the body (head and neck: r=0.22, upper extremities: r=0.26, trunk: r=0.48, and lower extremities: r=0.58). In conclusion, AC and NAC FDG-PET/CT images may be utilized to evaluate lesions in subjects with moderate-to-severe psoriasis. Our methodology could have future implications in the diagnosis and therapeutic management of psoriasis.
银屑病皮肤病变具有代谢活性，这使其成为使用18F氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（FDG-PET/CT）进行成像的候选对象。我们研究的目的是将FDG-PET检查结果与银屑病面积和严重程度指数（PASI）评分相关联，PASI评分是银屑病最广泛使用的分级系统。纳入了一项前瞻性临床试验[NCT01553058]中的33名受试者以及总共84次FDG-PET/CT扫描，这些受试者患有中度至重度银屑病超过2个月。受试者在静脉注射FDG后60分钟接受全身FDG-PET/CT成像，在治疗开始前进行。在基线扫描后以及开始治疗或给予安慰剂后12周和52周重复扫描。每个受试者和扫描图像均通过我们的“PET-PASI”评分系统进行分级，这是对衰减校正（AC）和未衰减校正（NAC）PET图像多平面重建的定性评估。使用Spearman等级相关分析将PASI和PET-PASI评分进行关联。我们的研究表明，在治疗或给予安慰剂之前和期间，每个受试者相应的PET-PASI和PASI评分之间存在显著正相关（r = 0.53，P < 0.001）。我们还发现全身不同区域的PET-PASI和PASI评分之间存在正相关（头颈部：r = 0.22，上肢：r = 0.26，躯干：r = 0.48，下肢：r = 0.58）。总之，AC和NAC FDG-PET/CT图像可用于评估中度至重度银屑病患者的病变。我们的方法可能对银屑病的诊断和治疗管理具有未来意义。
