J Rheum Dis.  2015 Dec;22(6):382-386. 10.4078/jrd.2015.22.6.382.

Clinical Implication of 18F-FDG-PET in Diagnosing and Monitoring Disease Activity in a Case of Subclinical Stage of Giant Cell Arteritis

• Yoo SJ
• Lee JC
• Kim Y
• Yoo IS
• Shim SC
• Kim KH
• Kang SW

• KMID: 2222813
• DOI: http://doi.org/10.4078/jrd.2015.22.6.382

Abstract

Giant cell arteritis (GCA) is a systemic vasculitis which typically occurs in persons over 50 years old. GCA is closely related to polymyalgia rheumatica (PMR). A temporal artery biopsy is the gold standard test for the diagnosis of GCA. Recently, there is increasing evidence for the role of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) in diagnosis of vasculitis. Here, we report on a case of a 67-year-old Korean male who was diagnosed with atypical GCA in subclinical stage concomitant with PMR by 18F-FDG-PET. After treatment, abnormal findings of 18F-FDG-PET were improved.

Keyword

Giant cell arteritis; Polymyalgia rheumatica; Positron emission tomography

MeSH Terms

Aged
Biopsy
Diagnosis
Giant Cell Arteritis*
Giant Cells*
Humans
Male
Polymyalgia Rheumatica
Positron-Emission Tomography
Systemic Vasculitis
Temporal Arteries
Vasculitis

Figure

• 

  Figure 1. 18 F-fluorodeoxyglucose positron emission tomography before treatment. There are increased glucose metabolism in the walls of the ascending aorta, aortic arch, thoracic descending aorta, both subclavian arteries, both common carotid arteries and especially both common femoral arteries and their large branches with wall thickening.

• 

  Figure 2. 18 F-fluorodeoxyglucose positron emission tomography after 12 months of treatment. There is no metabolic evidence of arteritis.

• 

  Figure 3. 18 F-fluorodeoxyglucose positron emission tomography images and aorta to liver maximal standardized uptake value ratio. (A) The aorta to liver ratio before treatment was 1.49 (thoracic aorta 3.45, liver 2.32). (B) The aorta to liver ratio after treatment was 0.98 (thoracic aorta 2.75, liver 2.80).

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