Abstract
Objective To explore the clinical value of 18F-fluorodeoxyglucose (FDG) PET/CT in assessing antineutrophil cytoplasmic antibody-associated vasculitis (AAV). Methods Fifteen patients(7 males, 8 females, age (66±11) years) with AAV between January 2015 and June 2017 were retrospectively analyzed. There were 6 patients diagnosed as granulomatosis with polyangiitis (GPA), 7 diagnosed as microscopic polyangiitis (MPA) and 2 diagnosed as eosinophilic granulomatosis with polyangiitis (EGPA). All patients underwent 18F-FDG PET/CT and the image features were observed and analyzed. The maximum standardized uptake value (SUVmax) of the positive lesion was measured. The relationship between the SUVmax and C reactive protein (CRP) was analyzed with Pearson correlation. The SUVmax and the number of lesion sites were compared by two-sample t test between the CRP-elevated and CRP-normal patients. Results A total of 56 lesions in the 14 of 15 AAV patients were detected by PET/CT. The positive findings distributed in 15 tissues and organs, including the nasopharynxes (n=9), lungs (n=9), kidneys (n=8), spleen (n=6), lymph nodes (n=6), bone marrow (n=4), skin (n=3), prostate (n=2), aortas (n=2), vertebral soft tissues (n=2), orbita (n=1), parotid gland (n=1), thyroid gland (n=1), liver (n=1) and pancreas (n=1). The 60.7% (34/56) of lesions were clinically unsuspected occult lesions. GPA lesions mainly invaded the nasopharynxes, lungs and kidneys; MPA lesions mainly invaded the kidneys and spleen; EGPA lesions mainly invaded the nasopharynxes, lymph nodes and bone marrow. There was no significant correlation between the level of CRP and the SUVmax of AAV lesions (r=0.462, P>0.05). No differences in the SUVmax were observed between patients with elevated CRP levels and those with normal CRP levels (t=1.451, P>0.05). But more lesion sites were observed in patients with elevated CRP (t=3.456, P<0.05). Conclusions 18F-FDG PET/CT shows positive findings in multiple sites in AAV patients, including clinically unsuspected sites. This imaging technique may be a useful tool for diagnosis and evaluation of AAV. Key words: Anti-neutrophil cytoplasmic antibody-associated vasculitis; Positron-emission tomography; Tomography, X-ray computed; Deoxyglucose
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