Imfeld Stephan, Scherrer Delia, Mensch Noemi, Aschwanden Markus, Staub Daniel, Berger Christoph T, Daikeler Thomas, Rottenburger Christof
Department of Angiology, University Hospital Basel, 4031 Basel, Switzerland.
Department of Rheumatology, University Hospital Basel, 4031 Basel, Switzerland.
Diagnostics (Basel). 2022 Mar 17;12(3):728. doi: 10.3390/diagnostics12030728.
We previously proposed standard uptake value (SUV) ratio-based cut-off values for [18F] fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) for diagnosing giant cell arteritis (GCA) with high diagnostic accuracy. Here we confirm our findings in an independent cohort and report a simplified procedure for using a SUV ratio to diagnose LV-GCA. Patients with suspected GCA were consecutively included. The ‘peak SUV ratio’ was defined in a two-step approach. First, the vessel with the visually brightest radiotracer uptake in the supra-aortic (SA) and in the aorto-iliofemoral (AIF) region was identified. Here, the maximum SUV of the vessel was measured and divided by the mean SUV of the liver (SUVratio). A ratio >1.0 in the SA or >1.3 in the AIF region was scored as vasculitis. The diagnostic accuracy, sensitivity, and specificity of the ‘peak SUV ratio’ in the SA and AIF region was assessed. From 2015 to 2019, 50 patients (24 female, median age 71 years) with suspicion of GCA were included, 28 patients with GCA and 22 patients with exclusion of GCA. Peak SUV had an AUC of 0.91, a sensitivity of 0.89, and a specificity of 0.73 for diagnosing GCA. Peak SUV accuracy of the AIF arteries was lower (AUC 0.81) than of the SA arteries (AUC 0.95). Our SUV ratio cut-off values for diagnosing GCA are consistently valid, also when applied in a time-efficient clinical procedure focusing on the peak SUV ratio. The diagnostic performance of PET/CT in this validation cohort was even higher, compared to the inception cohort (AUC of 0.83).
我们之前提出了基于标准摄取值（SUV）比值的[18F]氟脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）的截断值，用于诊断巨细胞动脉炎（GCA），具有较高的诊断准确性。在此，我们在一个独立队列中证实了我们的发现，并报告了一种使用SUV比值诊断局限性GCA的简化程序。连续纳入疑似GCA的患者。“峰值SUV比值”通过两步法定义。首先，确定在主动脉弓上（SA）和主动脉-髂股（AIF）区域放射性示踪剂摄取视觉上最亮的血管。在此，测量该血管的最大SUV，并除以肝脏的平均SUV（SUV比值）。SA区域比值>1.0或AIF区域比值>1.3被判定为血管炎。评估了SA和AIF区域“峰值SUV比值”的诊断准确性、敏感性和特异性。2015年至2019年，纳入50例疑似GCA的患者（24例女性，中位年龄71岁），其中28例为GCA患者，22例排除GCA患者。峰值SUV诊断GCA的曲线下面积（AUC）为0.91，敏感性为0.89，特异性为0.73。AIF动脉的峰值SUV准确性（AUC 0.81）低于SA动脉（AUC 0.95）。我们用于诊断GCA的SUV比值截断值始终有效，即使应用于聚焦峰值SUV比值的高效临床程序中也是如此。与初始队列（AUC为0.83）相比，该验证队列中PET/CT的诊断性能更高。
