Illustrate the advantages of utilising 18 F-FDG PETinthe diagnosis oflarge vessel vasculitis (LVV). Demonstrate through our patient series how 18 F-FDG PET may be a useful non-invasive imaging modality in the investigation of patients with suspected LVV. Outline the expected PET findings in these patients.
LVV is a term used to describe a range of idiopathic chronic primary vasculitides characterised by granulomatous inflammation affecting the aorta and its major branches.
The major variants are giant cell arteritis (GCA) and Takayasu arteritis (TA). GCA usually affects persons over the age of 50,
with a higher incidence reported in Northern European women at a ratio of 2.5:1..
TA is a rare disease usually found in young females.
It is being increasingly recognised in Europe with reported...
Findings and procedure details
ongoing inflammation leads to locally increased metabolic demands resulting in an increased cellular uptake of a radiolabelled glucose analogue ( 18 F-FDG).
This is reflected by increased radiotracer uptake in the walls of affected vessels. The affected large vessels include: · Aorta and its main branches,
especially within the thorax · Internal and external carotid arteries and their branches GCA primarily affects extracranial large vessels with or without involvement of the cranial...
18 F-FDG PET should be considered as a non-invasive imaging modality in patients presenting with a combination of non-specific systemic symptoms,
elevated inflammatory markers and unremarkable findings on conventional cross-sectional imaging with a clinical suspicion of LVV. Studies have indicated that this modality shows an overall good sensitivity and specificity in the diagnosis of LVV,
expediting diagnosis and assessing disease extent prior to the development of complications.
Epidemiology of giant cell arteritis: a critical review,Rheumatology,
1 July 2014,
Pages i1–i2. Onen F,
Epidemiology of Takayasu arteritis.
2017 Jul - Aug;46(7-8 Pt 2) e197-e203.
PMID: 28756072. Hunder G G,
Bloch D A,
Michel B A,
Stevens M B,
Arend W P,
Calabrese L H,
Edworthy S M,
Fauci A S,
Leavitt R Y,
Lie J T,
Lightfoot R W,
Masi A T,
McShane D J,
Mills J A,
Wallace S L and Zvaifler N J.