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Is positron emission tomography/magnetic resonance imaging a reliable tool for detecting vascular activity in treated childhood-onset Takayasu’s arteritis? A multicentre study

2021; Oxford University Press; Volume: 61; Issue: 2 Linguagem: Inglês

10.1093/rheumatology/keab255

1462-0332

Gleice Clemente, Rosa Maria Rodrigues Pereira, Nádia Emi Aikawa, Clóvis A. Silva, Lúcia Maria Arruda Campos, Gabriel Alves, Carlos Alberto Buchpiguel, Marcos Antônio Barbosa de Lima, Camila de Godoi Carneiro, Hilton Leão Filho, Fernando Morbeck, Guilherme de Carvalho Campos Neto, Vicente Odone Filho, Alexandre Wagner Silva de Souza, Maria Teresa Terreri,

Systemic Lupus Erythematosus Research

Toassess whether 18F-fluordeoxiglucose (18F-FDG) PET/MRI) with angiographic sequences can contribute to detecting vessel wall inflammation in patients with childhood-onset Takayasu's arteritis (c-TA) under immunosuppressive therapy.A three-centre cross-sectional study was conducted. 18F-FDG PET/MRI scans were performed in c-TA patients and in oncologic patients, who served as the control group. Clinical and laboratory characteristics were also analysed.Seventeen c-TA patients (65% females) between the ages of 6 and 21 years with a mean disease duration of 9.4 years were recruited. Only one patient presented clinical disease activity and six (35.6%) had increased ESR and/or CRP levels. The most frequent magnetic resonance angiography (MRA) findings were stenosis and thickening, observed in 82.4 and 70.6% of c-TA patients, respectively. 18F-FDG PET revealed 18F-FDG uptake greater than the liver in at least one arterial segment in 15 (88.2%) patients in a qualitative analysis and a median maximum standardized uptake value (SUVmax) of 3.22 (interquartile range 2.76-3.69) in a semi-quantitative analysis. c-TA patients presented significantly higher SUVmax values than oncologic patients (P < 0.001). A positive correlation between SUVmax and CRP levels (ρ = 0.528, P = 0.029) was seen.A state-of-the-art imaging modality was used in c-TA patients and revealed a strong arterial FDG uptake even in patients in apparent remission. We suppose that this finding may represent silent activity in the vessel wall; however, we cannot exclude the possibility of arterial remodelling. Importantly, a negative imaging scan may help in immunosuppression withdrawal in daily clinical practice.