Nienhuis Pieter H, van Nieuwland Marieke, van Praagh Gijs D, Markusiewicz Karolina, Colin Edgar M, van der Geest Kornelis S M, Wagenaar Nils, Brouwer Elisabeth, Alves Celina, Slart Riemer H J A
University of Groningen, University Medical Center Groningen, Medical Imaging Center, Department of Nuclear Medicine and Molecular Imaging, 9713 GZ Groningen, The Netherlands.
Hospital Group Twente, Department of Rheumatology and Clinical Immunology, 7600 SZ Almelo, The Netherlands.
Diagnostics (Basel). 2023 Dec 27;14(1):62. doi: 10.3390/diagnostics14010062.
(1) Background: In giant cell arteritis (GCA), the assessment of cranial arteries using [F]fluorodeoxyglucose ([F]FDG) positron emission tomography (PET) combined with low-dose computed tomography (CT) may be challenging due to low image quality. This study aimed to investigate the effect of prolonged acquisition time on the diagnostic performance of [F]FDG PET/CT in GCA. (2) Methods: Patients with suspected GCA underwent [F]FDG-PET imaging with a short acquisition time (SAT) and long acquisition time (LAT). Two nuclear medicine physicians (NMPs) reported the presence or absence of GCA according to the overall image impression (gestalt) and total vascular score (TVS) of the cranial arteries. Inter-observer agreement and intra-observer agreement were assessed. (3) Results: In total, 38 patients were included, of whom 20 were diagnosed with GCA and 18 were without it. Sensitivity and specificity for GCA on SAT scans were 80% and 72%, respectively, for the first NMP, and 55% and 89% for the second NMP. On the LAT scans, these values were 65% and 83%, and 75% and 83%, respectively. When using the TVS, LAT scans showed especially increased specificity (94% for both NMPs). Observer agreement was higher on the LAT scans compared with that on the SAT scan. (4) Conclusions: LAT combined with the use of the TVS may decrease the number of false-positive assessments of [F]FDG PET/CT. Additionally, LAT and TVS may increase both inter and intra-observer agreement.
(1) 背景：在巨细胞动脉炎（GCA）中，由于图像质量较低，使用[F]氟脱氧葡萄糖（[F]FDG）正电子发射断层扫描（PET）联合低剂量计算机断层扫描（CT）评估颅动脉可能具有挑战性。本研究旨在探讨延长采集时间对[F]FDG PET/CT在GCA诊断性能中的影响。(2) 方法：疑似GCA的患者接受了短采集时间（SAT）和长采集时间（LAT）的[F]FDG-PET成像。两名核医学医师（NMPs）根据颅动脉的整体图像印象（格式塔）和总血管评分（TVS）报告是否存在GCA。评估了观察者间一致性和观察者内一致性。(3) 结果：总共纳入38例患者，其中20例被诊断为GCA，18例未患GCA。对于第一位NMP，SAT扫描对GCA的敏感性和特异性分别为80%和72%，对于第二位NMP分别为55%和89%。在LAT扫描中，这些值分别为65%和83%，以及75%和83%。使用TVS时，LAT扫描显示特异性尤其增加（两位NMP均为94%）。与SAT扫描相比，LAT扫描的观察者一致性更高。(4) 结论：LAT结合TVS的使用可能会减少[F]FDG PET/CT假阳性评估的数量。此外，LAT和TVS可能会提高观察者间和观察者内的一致性。
