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AB0572 Additional Role of FDG Pet/Ct in the Assessment of Disease Activity in Takayasu Arteritis
  1. E. Tombetti1,2,
  2. E. Incerti2,
  3. A. Salerno1,2,
  4. S. Sartorelli1,
  5. M.C. Di Chio1,
  6. P. Alongi2,
  7. F. Fallanca2,
  8. M. Papa2,
  9. L. Gianolli2,
  10. M.G. Sabbadini1,2,
  11. A.A. Manfredi1,2,
  12. M. Picchio2,
  13. F. De Cobelli1,2,
  14. E.M. Baldissera2
  1. 1Vita-Salute San Raffaele University
  2. 2San Raffaele University Hospital, Milan, Italy

Abstract

Background Takayasu arteritis (TA) is an inflammatory vasculitis, typically affecting young women with important morbidity and mortality and a largely unknown pathogenesis. Disease activity (DA) evaluation is still a major unresolved issue, currently defined according to NIH criteria.

Objectives Evaluation of the additional role of PET/CT with FDG (PET/CT) in the assessment of DA status.

Methods A cross-sectional analysis of 19 patients (pts) with definite TA was performed. DA was evaluated with NIH criteria, and all pts underwent PET/CT and magnetic resonance angiography (MRA) examinations, with a median interval of 60 days. All vascular lesions uptake in PET/CT was evaluated both with a qualitative and a quantitative (SUV max) method. The capability of MRA and PET/CT in detecting active vascular inflammation was compared in all the lesions evaluable for dimensions with PET/CT. DA as assessed by MRA and PET/CT was compared with DA by NIH criteria.

Results In 11/19 pts PET/CT was positive with a median SUVmax of 3.5 (range: 2.7-9.8). Of the 89 vascular lesions evidenced by MRI and evaluable with PET/CT, 24 (27%) showed a positive uptake. Three out of 6 pts with active disease at the time of MRA showed vascular enhancement in at least one lesion, while vascular enhancement was observed in 4/13 pts with inactive disease. Two out of 5 pts with active disease at the time of PET/CT showed vascular uptake in at least one vascular lesion, while vascular uptake was observed 9/14 pts with inactive disease. Five out of 11 pts with evidence of uptake on PET/CT showed vascular enhancement at MRI, while 3/8 pts with a negative PET/CT showed vascular enhancement at MRI.

Conclusions NIH criteria, MRI, and PET/CT are non-redundant modalities of addressing DA in TA, possibly giving complementary information. Prospective evaluation of these preliminary results is needed to define the precise role of a multi-modality assessment of DA in TA.

Disclosure of Interest None declared

DOI 10.1136/annrheumdis-2014-eular.5497

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