Issue: 2003 > October > original article

F-18-fluorodeoxyglucose positron emission tomography in diagnosis and follow-up of patients with different types of vasculitis

C.P. Bleeker-Rovers, S.J.H. Bredie, J.W.M. van der Meer, F.H.M. Corstens, W.J.G. Oyen


Background: F-18-fluorodeoxyglucose (FDG) ccumulates
in inflammatory cells due to an increased metabolic rate.
Therefore, FDG positron emission tomography (PET)
represents a promising imaging technique in patients
with vasculitis. The aim of this study was to assess the
value of FDG PET in the diagnosis of different types of
Methods: The results of FDG PET performed because of
suspected vasculitis or fever of unknown origin with
results indicating vasculitis were reviewed. These results
were compared with the final diagnosis, based on the
American College of Rheumatology 1990 criteria.
Results: FDG PET was ordered because of suspected
vasculitis in 20 patients, because of fever of unknown
origin in two patients, and for follow-up of vasculitis in
five patients. Fourteen patients were diagnosed with
vasculitis (giant cell arteritis n=5, polymyalgia rheumatica n=2, polyarteritis nodosa n=3, Takayasu n=1, Churge-Strauss n=1, Wegener’s granulomatosis n=1, vasculitis skin n=1), two patients were diagnosed with fibromuscular dysplasia and one patient had media necrosis of the aorta. In five patients no diagnosis could be reached. FDG PET results were considered to be true-positive in ten patients, truenegative in 14 patients and false-negative in three patients resulting in a positive predictive value of 100% and a negative predictive value of 82%.
Conclusions: FDG PET appears to be a promising new
imaging technique in diagnosing and determining the
extent of various forms of vasculitis. Furthermore, FDG
PET may become a useful tool for evaluating the effect of
treatment of vasculitis.