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May 31, 20260 citationsOpen Access

Whole-body Dynamic 18FFDG-PET/CT in Giant Cell Arteritis and Polymyalgia Rheumatica.

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BSBert-Ram SahAEAlexey EyrikhLHLars Husmann

Key Points

  • This study investigates the diagnostic effectiveness of whole-body dynamic PET/CT in assessing giant cell arteritis and polymyalgia rheumatica.
  • Prospectively enrolled 25 patients with suspected GCA and/or PMR.
  • Utilized dynamic PET/CT scanning with multibed multipass acquisition before treatment.
  • Calculated metabolic rate of 18F-FDG using Patlak analysis and measured target-to-background ratio (TBR).
  • 68% of patients showed pathological FDG uptake; GCA diagnosed in 20%, PMR in 24%, both conditions in 24%.
  • TBR difference between dynamic and static PET was significant in both GCA and PMR (GCA P<0.003, PMR P<0.003).
  • Both dPET and static PET TBRs were significantly higher in diseased patients compared to healthy controls.

Abstract

Objectives We aimed to explore the diagnostic efficacy of whole-body dynamic (WBD) acquisition using 18F-Fluorodeoxyglucose-positron-emission-tomography/computed-tomography (18FFDG-PET/CT) for the assessment of giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) compared with the standard static PET/CT.Methods Twenty-five patients with suspected GCA and/or PMR were prospectively enrolled in this single-center study. WBD PET imaging was performed before treatment using a standard PET/CT scanner with a multibed multipass dynamic whole-body acquisition approach (dPET). Reconstructed datasets were used to generate metabolic rate of 18FFDG (MRFDG) images based on standard Patlak analysis. In case of pathologic FDG uptake, VOIs placed in vessel walls and joints were used for quantitation and definition of the target-to-background ratio (TBR): uptake in VOIs of vessel walls and joints (maximum values), to VOIs in blood pool (GCA), or to VOIs in normal muscles (PMR) (mean values). The final diagnosis based on the available imaging and laboratory results (except dPET), served as the standard of reference.Results Seventeen of the 25 patients (68%) showed pathologic FDG uptake, of which 5 (20%) were finally diagnosed with GCA alone, 6 (24%) with PMR alone, and another 6 (24%) with both conditions. TBR difference between dPET and static PET was significant in both diseases(GCA P<0.003, PMR P<0.003), and TBRs of dPET and static PET were significantly higher in both diseases compared with the healthy controls.Conclusions WBD 18FFDG-PET/CT provided a significantly higher TBR in patients with GCA and PMR compared with standard static PET imaging. WBD 18FFDG-PET/CT may potentially enhance the diagnostic accuracy in detecting GCA and PMR.

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Cite This Study

Sah et al. (2026) studied this question.

synapsesocial.com/papers/6a1bd2675783ba022b6fdeedhttps://doi.org/10.48620/98090
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