Expulsion of Placenta Praevia in Advance of Foetus

Abstract

<h3>Background</h3> The study aimed to evaluate the use of positron emission tomography/computed tomography (PET/CT) with ⁶⁸Ga-PRGD2 as the tracer for imaging of synovial angiogenesis in patients with rheumatoid arthritis (RA). <h3>Methods</h3> Twenty untreated active patients with RA underwent ⁶⁸Ga-PRGD2 PET/CT and ¹⁸F-FDG PET/CT before treatment; two patients with osteoarthritis served as controls. Among the 20 patients with RA, 12 repeated the evaluations after 3-month treatment. The image findings were correlated with core variables of disease activity, including the clinical disease activity index (cDAI). <h3>Results</h3> Our findings demonstrated that ⁶⁸Ga-PRGD2 specifically accumulated in the synovia with active inflammation rich in neovasculature with high-level α_vβ₃-integrin expression, but not in the ¹⁸F-FDG-avid inflammatory lymph nodes. In patients with intense ¹⁸F-FDG uptake in muscles caused by arthritic pain, we observed that ⁶⁸Ga-PRGD2 PET/CT was better able to evaluate disease severity than ¹⁸F-FDG PET/CT. Both ⁶⁸Ga-PRGD2 accumulation and ¹⁸F-FDG uptake changed in response to therapeutic intervention, whereas the changes of ⁶⁸Ga-PRGD2, not ¹⁸F-FDG, significantly correlated with clinical measures of changes in the form of cDAI. <h3>Conclusions</h3> This is the first integrin imaging study conducted in patients with RA that preliminarily indicates the effectiveness of the novel method for evaluating synovial angiogenesis. <h3>Clinical trial registration</h3> This study has been registered online at NIH ClinicalTrial.gov (NCT01940926).