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Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement

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

Abstract

Purpose

The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA).

Methods

We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen’s kappa concordance index.

Results

We included 28 patients (21/7 women/men, median age 67 [56–82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1–7] and 3 [1–6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64–1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54–0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively.

Conclusions

CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta’s branches.

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Acknowledgements

The authors thank Dr. Alison Johnson for proofreading the manuscript.

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Authors and Affiliations

  1. Department of Internal Medicine, Caen University Hospital, Avenue de la Côte de Nacre, 14000, Caen, France

    Hubert de Boysson, Anael Dumont, Jonathan Boutemy, Gwénola Maigné, Nicolas Martin Silva, Audrey Sultan, Boris Bienvenu & Achille Aouba

  2. Department of Internal Medicine, Limoges University Hospital, Limoges, France

    Eric Liozon & Kim Heang Ly

  3. Department of Internal Medicine, Lille University Hospital, Lille, France

    Marc Lambert

  4. Department of Nuclear Medicine, Caen University Hospital, Caen, France

    Nicolas Aide & Alain Manrique

  5. INSERM U1086 “ANTICIPE”, François Baclesse Cancer Centre, Caen, France

    Nicolas Aide

  6. Normandy University, EA4650, Caen, France

    Alain Manrique

Authors
  1. Hubert de Boysson
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  2. Anael Dumont
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  3. Eric Liozon
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  4. Marc Lambert
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  9. Kim Heang Ly
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  10. Nicolas Aide
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Corresponding author

Correspondence to Hubert de Boysson.

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Conflict of interest

The authors declare that they have no competing interests.

Ethical approval

This study was in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

In accordance with French public health law (Art. L 1121–1-1, Art. L 1121–1-2), formal informed consent is not required for this type of study (retrospective observational study).

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de Boysson, H., Dumont, A., Liozon, E. et al. Giant-cell arteritis: concordance study between aortic CT angiography and FDG-PET/CT in detection of large-vessel involvement. Eur J Nucl Med Mol Imaging 44, 2274–2279 (2017). https://doi.org/10.1007/s00259-017-3774-5

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  • DOI: https://doi.org/10.1007/s00259-017-3774-5

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