Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study

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• 作者：Ingo Einspieler ; Klaus Thürmel ; Thomas Pyka…
• 关键词：PET ; MRI ; PET/MRI ; Vasculitis ; Large vessel vasculitis ; Inflammation
• 刊名：European Journal of Nuclear Medicine and Molecular Imaging
• 出版年：2015
• 出版时间：June 2015
• 年：2015
• 卷：42
• 期：7
• 页码：1012-1024
• 全文大小：3,144 KB
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• 作者单位：Ingo Einspieler (1)
  Klaus Thürmel (2)
  Thomas Pyka (1)
  Matthias Eiber (1)
  Sabine Wolfram (2)
  Philipp Moog (2)
  Christian Reeps (3)
  Markus Essler (4)
  
  1. Department of Nuclear Medicine, Technische Universit?t München, Klinikum rechts der Isar, Ismaningerstr. 22, 81675, Munich, Germany
  2. Department of Nephrology, Technische Universit?t München, Klinikum rechts der Isar, Munich, Germany
  3. Department of Vascular Surgery, Klinikum rechts der Isar, Technische Universit?t München, Munich, Germany
  4. Department of Nuclear Medicine, Universit?tsklinikum Bonn, Rheinische Friedrich-Wilhelms-Universit?t, Bonn, Germany
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Nuclear Medicine
  Imaging and Radiology
  Orthopedics
  Cardiology
  Oncology
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1619-7089

文摘

Purpose The aim of this study was to evaluate the feasibility of hybrid [18F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI in patients with large vessel vasculitis (LVV) by comparing visual and quantitative parameters to that of PET/CT. Furthermore, the value of PET/MRI in disease activity and extent of LVV was assessed. Methods A total of 16 [18F]FDG PET/MRI and 12 [18F]-FDG PET/CT examinations were performed in 12 patients with LVV. MRI of the vessel wall by T1-weighted and T2-weighted sequences was used for anatomical localization of FDG uptake and identification of morphological changes associated with LVV. In addition, contrast-enhanced (CE) magnetic resonance angiography (MRA) was performed. The vascular FDG uptake in the vasculitis group was compared to a reference group of 16 patients using a four-point visual score. Visual scores and quantitative parameters [maximum standardized uptake value (SUV_max) and target to background ratio (TBR)] were compared between PET/MRI and PET/CT. Furthermore, correlations between C-reactive protein (CRP) and quantitative PET results, as well the extent of vasculitis in PET, MRI/CE-MRA and combined PET/MRI, were analysed. Results TBRs, SUV_max values and visual scores correlated well between PET/MRI and PET/CT (r--.92, r--.91; r--.84, p-lt;-.05). There was no significant difference between both modalities concerning SUV_max measurements and visual scores. In PET/MRI, PET alone revealed abnormal FDG uptake in 86 vascular regions. MRI/CE-MRA indicated 49 vessel segments with morphological changes related to vasculitis, leading to a total number of 95 vasculitis regions in combination with PET. Strong and significant correlations between CRP and disease extent in PET alone (r--.75, p--.0067) and PET/MRI (r--.92, p-lt;-.0001) in contrast to MRI/CE-MRA only were observed. Regarding disease activity, no significant correlations were seen between quantitative PET results and CRP, although there was a trend towards significance (r--.55, p--.0651). PET/MRI also showed active LVV in 15/16 examinations. Conclusion Hybrid PET/MRI is feasible in LVV and holds promise for precisely determining disease extent and disease activity.