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The feasibility of quantitative assessment of dynamic 18F-fluorodeoxyglucose PET in Takayasu’s arteritis: a pilot study

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

PET has been demonstrated to be sensitive for detecting active inflammation in Takayasu’s arteritis (TAK) patients, but semi-quantitative-based assessment may be susceptible to various biological and technical factors. Absolute quantification via dynamic PET (dPET) may provide a more reliable and quantitative assessment of TAK-active arteries. The purpose of this study was to investigate the feasibility and efficacy of dPET in quantifying TAK-active arteries compared to static PET.

Materials and methods

This prospective study enrolled 10 TAK-active patients (fulfilled the NIH criteria) and 5 control participants from March to October 2022. One-hour dPET scan (all TAK and control participants) and delayed static PET scan at 2-h (all TAK patients) were acquired. For 1-h static PET, summed images from 50 to 60 min of the dPET were extracted. PET parameters derived from 1- and 2-h static PET including SUV (SUV1H and SUV2H), target-to-background ratio (TBR) (TBR1H and TBR2H), net influx rate (Ki), and TBRKi extracted from dPET were obtained. The detectability of TAK-active arteries was compared among different scanning methods using the generalized estimating equation (GEE) with a logistic regression with repeated measures, and the GEE with gamma distribution and log link function was used to evaluate the different study groups or scanning methods.

Results

Based on the disease states, 5 cases of TAK were classified as untreated and relapsed, respectively. The SUVmax on 2-h PET was higher than that on 1-h PET in the untreated patients (P < 0.05). However, no significant differences were observed in the median SUVmax between 1-h PET and 2-h PET in the relapsed patients (P > 0.05). The TBRKi was significantly higher than both TBR1H and TBR2H (all P < 0.001). Moreover, the detectability of TAK-active arteries by dPET-derived Ki was significantly higher than 1-h and 2-h PET (all P < 0.001). Significant differences were observed in Kimax, SUVmax-1H, TBR1H, and TBRKi among untreated, relapsed, and control groups (all P < 0.05).

Conclusions

Absolute quantitative assessment by dPET provides an improved sensitivity and detectability in both visualization and quantification of TAK-active arteries. This elucidates the clinical significance of dPET in the early detection of active inflammation and monitoring recurrence.

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Data availability

Data are available on request to the corresponding author.

Code availability

Not applicable.

Abbreviations

TAK:

Takayasu’s arteritis

[18F]FDG:

2-Deoxy-2-[18F]fluoro-D-glucose

PET:

Positron emission tomography

SUV:

Standardized uptake value

TBR:

Target-to-background ratio

SNR:

Signal-to-noise ratio

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Acknowledgements

We would like to thank Qi Ge (Central Research Institute, UIH Group) for her valuable advice and support on the statistical analysis of the data.

Funding

This study was supported by National Natural Science Foundation of China Grants (82202235), Natural Science Foundation of Shandong Province (ZR2022MH165) and the Academic Promotion Program of Shandong First Medical University (2019LJ005).

Author information

Author notes

  1. Li Chen, Ximing Wang, and Zhaoping Cheng contributed equally to this work.

Authors and Affiliations

  1. Department of Nuclear Medicine, The First Affiliated Hospital of Shandong First Medical University & Shandong Provincial Qianfoshan Hospital, Jinan, 250014, China

    Yanhua Duan, Keyu Zan, Minjie Zhao, Hui Li, Min Ge, Leiying Chai, Xiao Cui, Wenjin Quan, Kun Li & Zhaoping Cheng

  2. Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, 250117, China

    Keyu Zan & Minjie Zhao

  3. Central Research Institute, United Imaging Healthcare Group Co., Ltd, Shanghai, China

    Yee Ling Ng & Yun Zhou

  4. Department of Ultrasound, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 250021

    Li Chen

  5. Department of Radiology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China, 250021

    Ximing Wang

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  1. Yanhua Duan
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Contributions

Study conception and design: Yanhua Duan, Li Chen, Ximing Wang and Zhaoping Cheng. Material preparation, data collection and analysis were performed by Yanhua Duan, Keyu Zan, Minjie Zhao, Yee Ling Ng, Hui Li, Min Ge, Leiying Chai, Xiao Cui, Wenjin Quan and Kun Li. The first draft of the manuscript was written by Yanhua Duan, and all authors commented on previous versions of the manuscript. Manuscript revision: Yun Zhou, Li Chen, Ximing Wang and Zhaoping Cheng. All authors commented on previous versions of the manuscript and read and approved the final manuscript.

Corresponding authors

Correspondence to Li Chen, Ximing Wang or Zhaoping Cheng.

Ethics declarations

Ethics approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards. This prospective study was performed from March 2022 to October 2022 with approval from the Hospital Ethics Committee (no.2022-S377).

Consent to participate

All the enrolled patients have signed the informed consent prior to the examination.

Consent for publication

Patients signed informed consent regarding publishing their data and photographs for scientific use.

Conflict of interest

Y.Ng. and Y.Z. are full-time employees of United Imaging Healthcare, China, and have no relevant financial or non-financial interests to disclose. All the other authors have no relevant financial or non-financial interests to disclose.

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Yanhua Duan is first author.

Key points

dPET-derived Ki demonstrated a higher detectability of active arteries than static PET-derived SUVs in both untreated (69.5% vs 49.5% vs 36.8%, respectively, P < 0.001) and relapsed Takayasu’s arteritis patients (69.5% vs 42.1% vs 16.8%, respectively, P < 0.001).

dPET is feasible in a clinical setting and the utilization of quantitative dPET-derived TBR proves to be a more sensitive parameter compared to static PET-derived TBRs in both untreated and relapsed patients (all P < 0.001).

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Duan, Y., Zan, K., Zhao, M. et al. The feasibility of quantitative assessment of dynamic 18F-fluorodeoxyglucose PET in Takayasu’s arteritis: a pilot study. Eur J Nucl Med Mol Imaging 51, 81–92 (2023). https://doi.org/10.1007/s00259-023-06429-4

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