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European Journal of Nuclear Medicine and Molecular Imaging

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01.02.2012 | Original Article

The impact of ¹⁸F-FDG PET on the management of patients with suspected large vessel vasculitis

verfasst von: Martin Fuchs, Matthias Briel, Thomas Daikeler, Ulrich A. Walker, Helmut Rasch, Scott Berg, Quinn K. T. Ng, Heike Raatz, David Jayne, Ina Kötter, Daniel Blockmans, Maria C. Cid, Sergio Prieto-González, Peter Lamprecht, Carlo Salvarani, Zaharenia Karageorgaki, Richard Watts, Raashid Luqmani, Jan Müller-Brand, Alan Tyndall, Martin A. Walter

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 2/2012

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Abstract

Purpose

We aimed to assess the impact of ¹⁸F-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the management of patients with suspected large vessel vasculitis.

Methods

An international expert panel determined diagnoses and clinical management in patients with suspected large vessel vasculitis, with and without the results of ¹⁸F-FDG PET, respectively. The accuracy of the clinical diagnosis and the resulting clinical management with and without the ¹⁸F-FDG PET results were compared using logistic regression models.

Results

The analysis included 30 patients referred to a tertiary care centre with large vessel vasculitis and 31 controls. ¹⁸F-FDG PET had an overall sensitivity of 73.3% [95% confidence interval (CI) 54.1–87.7%], a specificity of 83.9% (95% CI 66.3–94.5%), a positive predictive value of 81.5% (95% CI 61.9–93.7%) and a negative predictive value of 76.5% (95% CI 58.8–89.3%). The diagnostic accuracy of ¹⁸F-FDG PET was higher in patients not receiving immunosuppressive drugs (93.3 vs 64.5%, p = 0.006). Taken in context with other available diagnostic modalities, the addition of ¹⁸F-FDG PET increased the clinical diagnostic accuracy from 54.1 to 70.5% (p = 0.04). The addition of ¹⁸F-FDG PET increased the number of indicated biopsies from 22 of 61 patients (36.1%) to 25 of 61 patients (41.0%) and changed the treatment recommendation in 8 of 30 patients (26.7%) not receiving immunosuppressive medication and in 7 of 31 patients (22.6%) receiving immunosuppressive medication.

Conclusion

¹⁸F-FDG PET is a sensitive and specific imaging tool for large vessel vasculitis, especially when performed in patients not receiving immunosuppressive drugs. It increases the overall diagnostic accuracy and has an impact on the clinical management in a significant proportion of patients.

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Titel: The impact of 18F-FDG PET on the management of patients with suspected large vessel vasculitis
verfasst von: Martin Fuchs
Matthias Briel
Thomas Daikeler
Ulrich A. Walker
Helmut Rasch
Scott Berg
Quinn K. T. Ng
Heike Raatz
David Jayne
Ina Kötter
Daniel Blockmans
Maria C. Cid
Sergio Prieto-González
Peter Lamprecht
Carlo Salvarani
Zaharenia Karageorgaki
Richard Watts
Raashid Luqmani
Jan Müller-Brand
Alan Tyndall
Martin A. Walter
Publikationsdatum: 01.02.2012
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 2/2012
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-011-1967-x

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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