82c1e022b40a0bcf31a1e8062ce594e7 309046.pdf d5b1d5247890ee867e4b9105faf828bd9b93ed8c 309046.pdf 0c3b81d294147c8646b45675a6448ab591f507c3bbf38a0128f821e862edd304 309046.pdf Title: 18F-FDG-PET/CT Scan for Detection of Large Vessel Involvement in Giant Cell Arteritis: Arteser Spanish Registry Subject: Background/Objectives: Imaging studies have transformed the diagnosis of large vessel vasculitis (LVV) involvement in giant cell arteritis (GCA). A positron emission tomography/computed tomography (PET/CT) scan with 18-fluorodeoxyglucose (18F-FDG) has emerged as a valuable tool for assessing LVV. We aimed to determine the utility of an 18F-FDG-PET/CT scan in detecting LVV in GCA in the ARTESER registry. Methods: The ARTESER study is a large multicenter, retrospective, longitudinal, and observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed with GCA across 26 tertiary hospitals from 1 June 2013 to 29 March 2019. Patients with a diagnosis of incidental GCA were included if they fulfilled specific criteria, including the ACR 1990 criteria, positive imaging examinations, or the expert clinical opinion of investigators. Differences between patients with positive and negative 18F-FDG-PET/CT scan results were analyzed using a bivariate model. A regression model assessed associations in patients with a positive scan, and the predictive capacity of the cumulative dose of glucocorticoids (GC) on PET scan outcomes was evaluated using ROC curve analysis. Results: Out of 1675 GCA patients included in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. The thoracic aorta was the most frequently affected. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as the number of days increased. Depending on the cumulative dosage of the GC, the 18F-FDG-PET/CT scan showed an AUC of 0.74, with a Youden index > 60 mg/day. Conclusions: Younger patients showed a higher probability of presenting LVV as detected by the 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of the GC influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation. Keywords: 18F-FDG-PET/CT scan; large vessel vasculitis; aortitis; giant cell arteritis; imaging; nuclear medicine Author: Paula Estrada, Marta Domínguez-Álvaro, Rafael B. Melero-González, Eugenio de Miguel, Maite Silva-Díaz, Jesús A. Valero, Ismael González, Julio Sánchez-Martín, Javier Narváez, Eva Galíndez, Javier Mendizábal, Carlota L. Iñiguez-Ubiaga, Luis Rodríguez-Rodríguez, Javier Loricera, Alejandro Muñoz, Patricia Moya-Alvarado, Patricia Moran-Álvarez, Vanessa A. Navarro-Ángeles, Carlos Galisteo, Santos Castañeda, Ricardo Blanco and on behalf of ARTESER Project Collaborative Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.25 CreationDate: Tue Oct 22 03:04:30 2024 CEST ModDate: Tue Oct 22 03:07:49 2024 CEST Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 12 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 490945 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- RFRMYN+VnURWPalladioL-Bold Type 1 Custom yes yes yes 10 0 YCEVSA+URWPalladioL-Bold Type 1 Custom yes yes yes 16 0 FSTFSI+URWPalladioL-Roma Type 1 Custom yes yes yes 22 0 TORXFZ+URWPalladioL-Ital Type 1 Custom yes yes yes 27 0 YQOTQA+VnURWPalladioL Type 1 Custom yes yes yes 32 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 48 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 51 0 LIJQPC+URWPalladioL-BoldItal Type 1 Custom yes yes yes 74 0 HCPSKZ+CMSY10 Type 1 Builtin yes yes yes 82 0 CGKPBM+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 108 0 CGKPBN+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 114 0 CGKPCO+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 120 0 CGKPCP+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 126 0 CGKPDA+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 129 0 CGKPDB+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 132 0 CGLABM+PalatinoLinotype-Roman TrueType MacRoman yes yes no 135 0 BOLMEN+SFRM0900 Type 1 Custom yes yes yes 150 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2025-03-15 02:42:56 CET RepresentationInformation: 309046.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2025-03-14 08:19:47 CET Size: 490945 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 297 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Study Design Destination: subsection.2.1 Item: Title: Study Population Destination: subsection.2.2 Item: Title: Variables Destination: subsection.2.3 Item: Title: Statistical Analysis Destination: subsection.2.4 Item: Title: Ethical Aspects Destination: subsection.2.5 Item: Title: Results Destination: section.3 Children: Item: Title: General Features of the Studied Population Destination: subsection.3.1 Item: Title: Multivariate Analysis Destination: subsection.3.2 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.6 Info: Title: 18F-FDG-PET/CT Scan for Detection of Large Vessel Involvement in Giant Cell Arteritis: Arteser Spanish Registry Author: Paula Estrada, Marta Domínguez-Álvaro, Rafael B. Melero-González, Eugenio de Miguel, Maite Silva-Díaz, Jesús A. Valero, Ismael González, Julio Sánchez-Martín, Javier Narváez, Eva Galíndez, Javier Mendizábal, Carlota L. Iñiguez-Ubiaga, Luis Rodríguez-Rodríguez, Javier Loricera, Alejandro Muñoz, Patricia Moya-Alvarado, Patricia Moran-Álvarez, Vanessa A. Navarro-Ángeles, Carlos Galisteo, Santos Castañeda, Ricardo Blanco and on behalf of ARTESER Project Collaborative Group Subject: Background/Objectives: Imaging studies have transformed the diagnosis of large vessel vasculitis (LVV) involvement in giant cell arteritis (GCA). A positron emission tomography/computed tomography (PET/CT) scan with 18-fluorodeoxyglucose (18F-FDG) has emerged as a valuable tool for assessing LVV. We aimed to determine the utility of an 18F-FDG-PET/CT scan in detecting LVV in GCA in the ARTESER registry. Methods: The ARTESER study is a large multicenter, retrospective, longitudinal, and observational study, promoted by the Spanish Society of Rheumatology. It included patients newly diagnosed with GCA across 26 tertiary hospitals from 1 June 2013 to 29 March 2019. Patients with a diagnosis of incidental GCA were included if they fulfilled specific criteria, including the ACR 1990 criteria, positive imaging examinations, or the expert clinical opinion of investigators. Differences between patients with positive and negative 18F-FDG-PET/CT scan results were analyzed using a bivariate model. A regression model assessed associations in patients with a positive scan, and the predictive capacity of the cumulative dose of glucocorticoids (GC) on PET scan outcomes was evaluated using ROC curve analysis. Results: Out of 1675 GCA patients included in the registry, 377 met the inclusion criteria of having an 18F-FDG-PET/CT scan. The majority were diagnosed with a cranial GCA phenotype, and 65% had LVV. The thoracic aorta was the most frequently affected. Cardiovascular disease, diabetes, and older age had a negative association with a positive scan outcome. The OR for having a positive 18F-FDG-PET/CTC scan was lower as the number of days increased. Depending on the cumulative dosage of the GC, the 18F-FDG-PET/CT scan showed an AUC of 0.74, with a Youden index > 60 mg/day. Conclusions: Younger patients showed a higher probability of presenting LVV as detected by the 18F-FDG-PET/CT scan. The timing of the examination and the cumulative dosage of the GC influenced the likelihood of a positive result, with earlier tests being more likely to detect inflammation. 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