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Letter
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}gmail.com

https://doi.org/10.1136/annrheumdis-2018-213376

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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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    Footnotes

    • Handling editor Josef S Smolen

    • Presented at This work has been previously presented at a conference and published as a conference abstract in 2018.

    • Contributors SB-R and LTa: contribution to conception and design of the study, interpretation of data, drafting the manuscript and final approval. EC: execution, analysis and interpretation of data, final approval. LTo: analysis and interpretation of data and final approval. CB: drafting the manuscript and final approval. GL, JB, CM, JA and SG: revising the manuscript critically and final approval. AM-P: contribution to conception and design of the study and final approval. AP and MTDC: execution, interpretation of data and final approval. OD and YA: contribution to conception and the design of the study, revising the manuscript critically and final approval. MM-C: contribution to conception and the design of the study, interpretation of data, revising the manuscript critically and final approval.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Ethics approval As case series, ethics committee approval was not required in accordance with the policy of our institution.

    • Provenance and peer review Not commissioned; externally peer reviewed.