Vaidyanathan, S, Chattopadhyay, A, Mackie, SL et al. (1 more author) (2018) Comparative effectiveness of ¹⁸F-FDG PET-CT and contrast-enhanced CT in the diagnosis of suspected large-vessel vasculitis. British Journal of Radiology, 91 (1089). e20180247. ISSN 0007-1285
Abstract
Objectives: Large-vessel vasculitis (LVV) is a serious illness with potentially life-threatening consequences. ¹⁸F-FDG PET-CT has emerged as a valuable diagnostic tool in suspected LVV, combining the strengths of functional and structural imaging. This study aimed to compare the accuracy of FDG PET-CT and contrast-enhanced CT (CECT) in the evaluation of patients with LVV.
Methods: A retrospective database review for LVV patients undergoing CECT and PET-CT between 2011 to 2016 yielded demographics, scan interval and vasculitis type. Qualitative and quantitative PET-CT analyses included aorta: liver FDG uptake, bespoke FDG uptake distribution scores and vascular maximum standardized uptake values (SUVmax). Quantitative CECT data were assessed wall thickness and mural/lumen ratio. ROC curves were constructed to evaluate comparative diagnostic accuracy and a correlational analysis was conducted between SUVmax and wall-thickness.
Results: 36 adults (17 LVV, 19 controls) with a mean age (range) 63 (38–89) years, of which 17 (47%) were males were included. Time interval between CT and PET was mean (standard deviation (SD)) 1.9 (1.2) months. Both SUVmax and wall-thickness demonstrated a significant difference between LVV and controls, with a mean difference (95%confidence interval (CI)) for SUVmax 1.6 (1.1, 2.0) and wall thickness 1.25 (0.68, 1.83) mm, respectively. These two parameters were significantly correlated (p < .0001, R = 0.62). The area under the curve (AUC) (95% CI) for SUVmax was 0.95 (0.88–1.00), and for mural thickening was 0.83 (0.66–0.99).
Conclusions: FDG PET-CT demonstrated excellent accuracy whilst CECT mural thickening showed good accuracy in the diagnosis of LVV. Both parameters showed a highly significant correlation. In hospitals without access to FDG PET-CT or in patients unsuitable for PET-CT (e.g., uncontrolled diabetes) CECT offers a viable alternative for the assessment LVV.
Advances in knowledge: FDG PET-CT is a highly accurate test for the diagnosis of LVV. Aorta:liver SUVmax ratio is the most specific parameter for LVV. In hospitals without PET-CT or in unsuitable patients e.g. diabetics, CECT is a viable alternative.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2018 The Authors. Published by the British Institute of Radiology. This is an author produced version of a paper published in British Journal of Radiology. Uploaded in accordance with the publisher's self-archiving policy. |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Inst of Biomed & Clin Sciences (LIBACS) (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 05 Jul 2018 13:06 |
Last Modified: | 21 Jun 2019 00:39 |
Status: | Published |
Publisher: | British Institute of Radiology |
Identification Number: | 10.1259/bjr.20180247 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:132952 |