Department of Nuclear Medicine, Saint-Luc University Clinics and Institute of Clinical and Experimental Research (IREC), Catholic University of Louvain (UCLouvain), Brussels, Belgium -
Department of Nuclear Medicine and PET Center, Aarhus University Hospital, Aarhus, Denmark.
Q J Nucl Med Mol Imaging. 2022 Sep;66(3):182-193. doi: 10.23736/S1824-4785.22.03465-3.
Large vessel vasculitides (LVV) are defined as chronic inflammatory disorders that affect the arteries with two major variants being distinguished: giant cell arteritis (GCA) and Takayasu's arteritis (TAK). These often present with nonspecific constitutional symptoms which makes an accurate diagnosis often challenging. Nevertheless, timely diagnosis is of utmost importance to initiate treatment and to avoid potential life-threatening complications. [F]FDG-PET/CT is nowadays widely accepted as useful tool to aid in the diagnosis of large vessel vasculitis. However, its role to monitor disease activity and to predict disease relapse during follow-up is less obvious since vascular [F]FDG uptake can be detected in the absence of clinical or biochemical signs of disease activity. In addition to the two major variants, [F]FDG-PET/CT has shown promise in (peri-)aortitis and related disorders. This article aims to provide an update on the current knowledge and limitations of [F]FDG-PET/CT for the diagnosis and assessment of treatment response in LVV. Furthermore, other radiopharmaceuticals targeting key components of the vascular immune system are being discussed which could provide an interesting alternative to image vascular inflammation in LVV.
大血管血管炎（LVV）被定义为慢性炎症性疾病，影响动脉，主要有两种变体：巨细胞动脉炎（GCA）和 Takayasu 动脉炎（TAK）。这些疾病常伴有非特异性全身症状，因此准确诊断常常具有挑战性。然而，及时诊断对于开始治疗和避免潜在的危及生命的并发症至关重要。[F]FDG-PET/CT 目前被广泛认为是辅助诊断大血管血管炎的有用工具。然而，其在监测疾病活动和预测随访期间疾病复发的作用并不明显，因为在没有临床或生化疾病活动迹象的情况下也可以检测到血管[F]FDG 摄取。除了这两种主要变体外，[F]FDG-PET/CT 在（peri-）主动脉炎和相关疾病中也显示出了希望。本文旨在提供关于[F]FDG-PET/CT 在 LVV 的诊断和治疗反应评估中的最新知识和局限性的更新。此外，还讨论了针对血管免疫系统关键成分的其他放射性药物，这可能为 LVV 中的血管炎症成像提供一种有趣的替代方法。
