Antunovic Lidija, Artesani Alessia, Coniglio Michael, Oyen Wim J G, Ciccarelli Michele, Selmi Carlo, Chiti Arturo, Sollini Martina
IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, 20089 Milan, Italy.
Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy.
Diagnostics (Basel). 2022 Nov 7;12(11):2717. doi: 10.3390/diagnostics12112717.
Diagnosis of vasculitis is challenging. To avoid invasive approaches, clinical guidelines recommend the use of diagnostic imaging. This study aimed at evaluating the diagnostic accuracy of [F]-fluorodeoxyglucose ([F]FDG) position emission tomography/computed tomography (PET/CT) in large vessel vasculitis (LVV) and how this is affected by inter-operator variability.
A total of 279 patients who performed [F]-FDG PET/CT for suspicion of LVV were retrospectively analyzed. We tested the qualitative and semi-quantitative analysis and parameters influencing image quality and interpretation. Exams were evaluated by two readers with different experience and their performance was compared.
LVV diagnosis was confirmed in 81 patients. [F]-FDG PET/CT accuracy was 73% and 67% for the expert reader and less experienced reader, respectively. The expert reader overall performed better than the less experienced one, with higher accuracy in patients with normal BMI (77.3 vs. 63.8%), normal level of glycemia (73.3 vs. 65%), younger age (76.6 vs. 68.2%), and when no therapy was in course at time of imaging (76.7 vs. 66.7%). The diagnostic performance of both readers did not improve using semi-quantitative parameters.
We confirmed the appropriateness of the recommended criteria for image acquisition and interpretation, underlining the importance of experience in image interpretation for the optimal diagnostic performance of [F]FDG PET/CT in vasculitis.
血管炎的诊断具有挑战性。为避免采用侵入性方法，临床指南推荐使用诊断性影像学检查。本研究旨在评估[F] - 氟脱氧葡萄糖（[F] FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在大血管血管炎（LVV）中的诊断准确性以及其如何受到操作者间变异性的影响。
回顾性分析了总共279例因怀疑患有LVV而进行[F] - FDG PET/CT检查的患者。我们测试了定性和半定量分析以及影响图像质量和解读的参数。由两位经验不同的阅片者对检查进行评估，并比较他们的表现。
81例患者确诊为LVV。对于经验丰富的阅片者和经验较少的阅片者，[F] - FDG PET/CT的准确率分别为73%和67%。总体而言，经验丰富的阅片者表现优于经验较少的阅片者，在体重指数正常（77.3%对63.8%）、血糖水平正常（73.3%对65%）、年龄较轻（76.6%对68.2%）以及成像时未进行治疗（76.7%对66.7%）的患者中准确率更高。使用半定量参数并未提高两位阅片者的诊断性能。
我们证实了推荐的图像采集和解读标准的适用性，强调了图像解读经验对于[F] FDG PET/CT在血管炎中实现最佳诊断性能的重要性。
