Abstract

Background18F-fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) represents one of the standard imaging modalities in the detection of giant cell arteritis (GCA). Detailed data regarding the vessel involvement in GCA are not available.ObjectivesThe aim of this study was to quantify arterial vessel involvement at the onset of GCA by 18F-FDG PET/CT and to verify the influence of glucocorticoid treatment on the diagnostic performance of 18F-FDG PET/CT.MethodsThis study included 60 patients (44 women and 16 men, mean age 72.8 ± 8.8 years) at the onset of GCA. All patients received a PET/CT. 44 patients were glucocorticoid naïve. 16 patient were treated with glucocorticoid (prednisone median dose 60 mg) 3.5 ± 4.4 days before the 18F-FDG PET/CT was performed. All 18F-FDG PET/CT scans were scored regarding the active inflammation of the large arteries.ResultsThe most affected arteries were the aorta ascendens (72 %), followed by truncus brachiocephalicus (62 %), acrus aortae (60 %), aorta descendens (60 %), left and right arteria sublcavia (60 % and 58 %). The aorta and their outgoing arteries presented an involvement in 39 GCA patients (89 %). A singular affection of the aorta was shown in 9 patients (20 %). glucocorticoid naïve patients (89 %) showed affected arteries more frequently than glucocorticoid treated patients (38 %).ConclusionThe study showed that the thoracic aorta (in particular aorta ascendens) is the most involved vascular segment in GCA. The use of glucocorticoids was associated with a marked decrease of vascular inflammation. Consequently, the imaging of the thoracic aorta should be included in the diagnostic procedure of GCA. 18F-FDG PET/CT should be performed without glucocorticoid treatment, if the clinical situation allowed this proceeding.Disclosure of InterestsLeander Malich: None declared, Falk Gühne: None declared, Tobias Hoffmann: None declared, Ansgar Malich: None declared, Peter Oelzner: None declared, Gunter Wolf: None declared, Martin Freesmeyer: None declared, Alexander Pfeil Grant/research support from: This study is a part of the Investigator Initiated study Retrospective analysis of clinical and imaging parameters to predict flair in patients with giant cell arteritis.” which is supported by Chugai Pharma Germany GmbH, Lyoner Straße 15, 60528 Frankfurth am Main.

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