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18F-fluorodeoxyglucose positron-emission tomography/CT and lung involvement in systemic sclerosis
  1. Silvia Bellando-Randone1,2,
  2. Luca Tartarelli3,
  3. Edorardo Cavigli4,
  4. Lorenzo Tofani5,
  5. Cosimo Bruni1,2,
  6. Gemma Lepri1,2,
  7. Jelena Blagojevic1,2,
  8. Alberto Moggi-Pignone6,
  9. Carina Mihai7,
  10. Jerome Avouac8,
  11. Alessandro Passeri3,
  12. Maria Teresa De Cristofaro3,
  13. Oliver Distler7,
  14. Yannick Allanore8,
  15. Serena Guiducci1,2,
  16. Marco Matucci-Cerinic1,2
  1. 1 Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
  2. 2 Division of Rheumatology AOUC, Department of Geriatric Medicine, University of Florence, Florence, Italy
  3. 3 Department of Biomedical, Experimental and Clinical Sciences, “Mario Serio”, Nuclear Medicine Unit, University of Florence, Florence, Italy
  4. 4 Department of Radiodiagnostic and Emergency, Careggi University Hospital, Florence, Italy
  5. 5 Department of Neurosciences, Psychology, Drug Research and Child Health, University of Florence, Florence, Italy
  6. 6 Internal Medicine of Careggi University Hospital, Florence, Italy
  7. 7 Department of Rheumatology, University Hospital Zurich, Zurich, Switzerland
  8. 8 Department of Rheumatology A, Cochin Hospital, INSERM U1016, Paris Descartes University, Paris, France
  1. Correspondence to Silvia Bellando-Randone, Department of Experimental and Clinical Medicine, University of Florence, Florence 50139, Italy; s.bellandorandone{at}

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Systemic sclerosis (SSc) early lung involvement (interstitial lung disease (ILD)) is characterised by ground glass opacities (GGO) at high-resolution CT (HRCT).1 2 The literature provides conflicting interpretations of GGO’s clinical significance,3–5 and whether it represents inflammation or early fibrotic changes is a dilemma. In fact, HRCT cannot discriminate between ‘active inflammatory’ and ‘established fibrotic’ GGO.6 Instead, 18-F fluoro-deoxy-d-glucose positron-emission tomography/CT (18F-FDG-PET/CT) locates areas of increased metabolic activity,7 8 but no data on the ‘established fibrotic’ GGO metabolic activity has been demonstrated yet. We aimed at evaluating if 18F-FDG-PET/CT scan may identify GGO inflammatory component in SSc-ILD.9

Seven patients with SSc (six females; mean age 59.56±9.15 years, median disease duration 5 years) from the Rheumatology Outpatient Clinic, University of Florence underwent a 18F-FDG-PET/CT to rule out the presence of a neoplasia for a lung nodule detected at chest HRCT. HRCT pulmonary segments were classified as ‘negative’ (normal morphology) and ‘positive’ (presence of GGO), and the Warrick score was used to quantify ILD at HRCT.10 18F-FDG-PET/CT images were retrospectively …

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