Wu Sifan, Wu Bing, Ma Lingying, Li Mengdi, Sun Xianting, Zhang Shuhui, Shi Hongcheng, Jiang Lindi
Department of Rheumatology, Zhongshan Hospital, Fudan University, 180 Fenglin Road, Shanghai, 200032, People's Republic of China.
Department of Nuclear Medicine, Zhongshan Hospital, Fudan University, Shanghai, People's Republic of China.
Eur J Nucl Med Mol Imaging. 2025 May 28. doi: 10.1007/s00259-025-07348-2.
Arterial wall Fluorodeoxyglucose (FDG) uptake can reflect vascular inflammation in Takayasu's arteritis (TAK); however, its association with vascular prognosis remains unclear. This study assessed the predictive efficacy of the PET vascular activity score (PETVAS) for vascular prognosis and whether FDG uptake in specific arterial territories was associated with angiographic progression in TAK.
Patients with TAK from a prospective observational cohort who underwent F-FDG PET/CT and serological tests at baseline were included. Magnetic Resonance Angiography and/or Contrast-Enhanced Ultrasound were conducted at baseline and every six months during follow-up. The PETVAS was calculated. New/aggravated lesions were considered as angiographic progression.
The imaging evaluation included 1,353 arterial territories from 123 patients. The baseline PETVAS was positively correlated with Erythrocyte Sedimentation Rate (ESR), serum IL-6, and Platelet. Angiographic progression was noted in 45 patients (36.6%) with 72 territories (5.3%) during 30 (18-72) months of follow-up. Of these, 19 (42.2%) had baseline PETVAS > 15, including 84.2% (16/19) naïve cases and 78.9% (15/19) with ESR ≥ 30 mm/h. Multivariate Cox proportional hazards regression analysis adjusted for age and sex showed baseline PETVAS > 15 (HR 1.93; 95% CI, 1.01-3.68; p = 0.04) an independent predictor of angiographic progression.
Baseline PETVAS > 15 was an independent predictor of angiographic progression in TAK. Baseline FDG uptake in specific arterial territories did not correlate with vascular progression. Our study provides a feasible PET/CT-based predictive marker for vascular progression in TAK and underscores the importance of regular imaging follow-up to monitor disease outcomes.
Not applicable.
动脉壁氟脱氧葡萄糖（FDG）摄取可反映大动脉炎（TAK）中的血管炎症；然而，其与血管预后的关联仍不清楚。本研究评估了PET血管活性评分（PETVAS）对血管预后的预测效能，以及TAK中特定动脉区域的FDG摄取是否与血管造影进展相关。
纳入来自前瞻性观察队列的TAK患者，这些患者在基线时接受了F-FDG PET/CT和血清学检查。在基线时以及随访期间每六个月进行一次磁共振血管造影和/或对比增强超声检查。计算PETVAS。新出现/加重的病变被视为血管造影进展。
影像学评估包括123例患者的1353个动脉区域。基线PETVAS与红细胞沉降率（ESR）、血清IL-6和血小板呈正相关。在30（18 - 72）个月的随访期间，45例患者（36.6%）的72个区域（5.3%）出现血管造影进展。其中，19例（42.2%）基线PETVAS>15，包括84.2%（16/19）初治病例和78.9%（15/19）ESR≥30 mm/h的病例。调整年龄和性别后的多因素Cox比例风险回归分析显示，基线PETVAS>15（HR 1.93；95% CI，1.01 - 3.68；p = 0.04）是血管造影进展的独立预测因素。
基线PETVAS>15是TAK血管造影进展的独立预测因素。特定动脉区域的基线FDG摄取与血管进展无关。我们的研究为TAK的血管进展提供了一种基于PET/CT的可行预测标志物，并强调了定期影像学随访以监测疾病转归的重要性。
不适用。
