A retrospective cohort study to assess PET-CT findings and clinical outcomes in Takayasu arteritis: does 18F-fluorodeoxyglucose uptake in arteries predict relapses?

Author(s)

Faria Janes, Anna Larissa ^[1] ; Castro, Miriam Fang ^[1] ; Diniz Arraes, Anne Elizabeth ^[1] ; Savioli, Bruna ^[1] ; Sato, Emilia Inoue ^[1] ; de Souza, Alexandre W. S. ^[1]

Affiliation

^[1] Univ Fed Sao Paulo, Escola Paulista Med, Dept Med, Rheumatol Div, Rua Botucatu 740 3 Andar, BR-04023900 Sao Paulo, SP - Brazil

• Document type: Journal article
• Source: RHEUMATOLOGY INTERNATIONAL; v. 40, n. 7, p. 1123-1131, JUL 2020.
• Web of Science Citations: 0

Abstract

The objective of this study is to investigate the use of PET-CT scan with 18F-fluorodeoxyglucose (18F-FDG) as a method to predict outcomes in patients with Takayasu arteritis (TAK), as well as to analyze associations between 18F-FDG PET-CT findings with disease relapses, sustained remission, new angiographic lesions, ischemic events, and changes in therapy for TAK. At baseline assessment, 36 TAK patients underwent 18F-FDG PET-CT scan and maximal standardized uptake value (SUVmax) in arteries >= 1.3 was predictive for clinical disease activity. Thirty-two TAK patients were then followed-up for a median 83.5 months. Twenty-three (71.9%) patients developed clinical relapses and new arterial lesions were observed in 14 (43.8%) cases. Disease relapses {[}85.0% vs. 50.0%, p = 0.049; odds ratio (OR): 5.667; 95% confidence interval (95 CI): 1.067-30.085] and the need for changing immunosuppressive therapy (85.0% vs. 41.7%, p = 0.018; OR: 7.933; 95CI: 1.478-42.581) were more frequently found in patients with SUVmax >= 1.3 at baseline compared with those presenting SUVmax < 1.3. No associations were found between SUVmax >= or < 1.3 in large arteries at baseline and the development of ischemic events, sustained remission or new angiographic lesions. In multivariate analysis, associations between baseline SUVmax >= 1.3 and disease relapses were not independent (hazard ratio: 1.07; 95 CI 0.39-2.92; p = 0.892). In conclusion, arterial SUVmax is marginally associated with disease relapses and with the need to change therapy in TAK. 18F-FDG uptake in large arteries is not associated with the development of new arterial lesions in TAK. (AU)