18F-Fluorodeoxyglucose positron-emission tomography (18F-FDG-PET) with computed tomography (CT) is effective for diagnosing large vessel vasculitis, but its usefulness in accurately diagnosing suspected, unselected vasculitis remains unknown. We evaluated the feasibility of 18F-FDG-PET/CT in real-life cohort of patients with suspicion of vasculitis. The effect of the dose and the timing of glucocorticoid (GC) medication on imaging findings were in special interest. 82 patients with suspected vasculitis were evaluated by whole-body 18F-FDG-PET/CT. GC treatment as prednisolone equivalent doses at the scanning moment and before imaging was evaluated. 38/82 patients were diagnosed with vasculitis. Twenty-one out of 38 patients had increased 18F-FDG accumulation in blood vessel walls indicating vasculitis in various sized vessels. Vasculitis patients with a positive vasculitis finding in 18F-FDG-PET/CT had a significantly shorter duration of GC use (median = 4.0 vs 7.0 days, P=0.034), and they used lower GC dose during the PET scan (median dose = 15.0 mg/day vs 40.0 mg/day, p=0.004) compared to 18F-FDG-PET/CT-negative patients. Vasculitis patients with a positive 18F-FDG-PET/CT result had significantly higher C-reactive protein (CRP) than patients with a negative 18F-FDG-PET/CT finding (mean value = 154.5 vs 90.4 mg/L, p=0.018). We found that 18F-FDG-PET/CT positivity was significantly associated with a lower dose and shorter duration of GC medication and higher CRP level in vasculitis patients. 18F-FDG-PET/CT revealed clinically significant information in over half of the patients and was effective in confirming the final diagnosis.

中文翻译：

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在怀疑血管炎的诊断中使用18F-FDG-PET / CT的临床影响：糖皮质激素治疗的剂量和时机的影响。

18F-氟脱氧葡萄糖正电子发射断层扫描（18F-FDG-PET）和计算机断层扫描（CT）对诊断大血管血管炎是有效的，但在准确诊断可疑，未选择的血管炎中的实用性仍然未知。我们评估了18F-FDG-PET / CT在怀疑血管炎患者的现实生活中的可行性。糖皮质激素（GC）的剂量和时间对影像学表现的影响尤其令人关注。通过全身18F-FDG-PET / CT对82例疑似血管炎患者进行了评估。在扫描时和成像前，以泼尼松龙当量的GC处理量进行评估。38/82例患者被诊断患有血管炎。38例患者中有21例在血管壁中18F-FDG积累增加，表明各种大小的血管均患有血管炎。在18F-FDG-PET / CT中发现阳性血管炎的血管炎患者的GC使用时间明显缩短（中位数= 4.0 vs 7.0天，P = 0.034），并且他们在PET扫描期间使用了较低的GC剂量（中位数=与18F-FDG-PET / CT阴性患者相比，15.0 mg /天与40.0 mg /天，p = 0.004）。18F-FDG-PET / CT结果阳性的血管炎患者的C反应蛋白（CRP）明显高于18F-FDG-PET / CT结果阴性的患者（平均值= 154.5 vs 90.4 mg / L，p = 0.018 ）。我们发现，在血管炎患者中，18F-FDG-PET / CT阳性与较低剂量和较短的GC药物治疗时间以及较高的CRP水平显着相关。18F-FDG-PET / CT在一半以上的患者中显示出临床上重要的信息，并有效地证实了最终诊断。