scholarly journals POS0811 EULAR RECOMMENDATIONS ON GIANT CELL ARTERITIS IN REAL LIFE

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 658.1-658
Author(s):  
F. Regola ◽  
F. Franceschini ◽  
G. Bosio ◽  
P. Toniati
Keyword(s):  
Initial Dose ◽  
Fdg Pet ◽  
Temporal Artery ◽  
Large Vessel ◽  
Temporal Artery Biopsy ◽  
Eular Recommendations ◽  
First Choice ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Vessel Involvement

Background:GCA is the most frequent systemic vasculitis in patients older than 50 years involving medium-sized and large arteries. On July 2019 EULAR published its updated recommendations for the management of large vessel vasculitis, including GCA.Objectives:To analyze how the application of the updated EULAR recommendations changed clinical practice in GCA patients in our Hospital.Methods:All patients with a new diagnosis of GCA between January 1st, 2018 and December 31st, 2020 were enrolled in this study. Two cohorts were analyzed: patients who received GCA diagnosis in the eighteen months before EULAR recommendations publication (between January 1st, 2018 and June 30th, 2019: cohort A) and patients who received GCA diagnosis in the following eighteen months (between July 1st, 2019 and December 31st, 2020: cohort B). Data are expressed as median (IQR).Results:70 patients were enrolled in the study (F: 47, M: 23, age: 76 (69-79) years): 39 patients in cohort A, 31 in cohort B. Table 1 summarize main clinical features and treatment of patients. Sixteen patients of cohort A (41%) and eleven patients of cohort B (35%) presented large vessel involvement demonstrated by FDG-PET/CT. Thirty-one patients in cohort A (79%) and twenty-seven in cohort B (87%) presented cranial symptoms and were studied with temporal arteries ultrasound (US) and/or biopsy (TAB). More specifically, in cohort A US was performed in 42% of patients with cranial symptoms and TAB in 58% of them. After EULAR recommendations publication (cohort B) the percentage of patients with cranial symptoms who performed US increased to 56% and the percentage of TAB decreased to 52%.After EULAR recommendations publication, time between symptoms onset and first rheumatologic evaluation was reduced by 30% (from 61 (23-131) to 43 (22-92) days).No difference in treatment regiments were found between groups, whether in glucocorticoid initial dose or DMARDs adjunctive therapy.Conclusion:After EULAR recommendations publication, two major improvement were achieved in our cohort. EULAR suggests GCA patients should be urgently referred to a specialist team. Consistently with this recommendation, time between symptoms onset and first rheumatologic evaluation was markedly reduced. Moreover, EULAR suggests always confirming GCA diagnosis by imaging or TAB, with US as first choice. In line with these recommendations, in our cohort US became more and more frequently performed and progressively preferred over TAB. On the other hand, no differences in treatment regiments were found over time, with EULAR recommendations satisfied both before and after their publication.References:[1]Hellmich B, et al. Ann Rheum Dis 2019.ALL GCA(n: 70)Before EULAR recommendations(n: 39)After EULAR recommendations (n: 31)Time between symptoms onset and first rheumatologic evaluation (days)53 (22-110)61 (23-131)43 (22-92)Temporal artery US28/58 (48%)13/31 (42%)15/27 (56%)Temporal artery biopsy32/58 (55%)18/31 (58%)14/27 (52%)Large vessel involvement (FDG-PET/CT)27 (39%)16 (41%)11 (35%)Glucocorticoid initial dose (mg/die prednisone equivalent)50 (47-50)50 (50-50)50 (38-50)DMARDs43 (61%)24 (61%)19 (61%)Disclosure of Interests:None declared

JAK Inhibitor Effectiveness in Giant-Cell Arteritis With Large-Vessel Involvement Assessed by 18F-FDG PET-CT

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Kevin Prigent ◽  
Achille Aouba ◽  
Nicolas Aide ◽  
Hubert de Boysson
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Large Vessel ◽  
Jak Inhibitor ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct ◽  
Vessel Involvement

scholarly journals The Role of18F-FDG PET/CT in Large-Vessel Vasculitis: Appropriateness of Current Classification Criteria?

2014 ◽  
Vol 2014 ◽  
pp. 1-13 ◽  
Author(s):  
H. Balink ◽  
R. J. Bennink ◽  
B. L. F. van Eck-Smit ◽  
H. J. Verberne
Keyword(s):  
Fdg Pet ◽  
Fatal Outcome ◽  
Clinical Suspicion ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Arterial Stenosis ◽  
Wall Thickening ◽  
Temporal Artery Biopsy ◽  
Pet Ct ◽  
Fdg Pet Ct

Patients with clinical suspicion of large-vessel vasculitis (LVV) may present with nonspecific signs and symptoms and increased inflammatory parameters and may remain without diagnosis after routine diagnostic procedures. Both the nonspecificity of the radiopharmaceutical18F-FDG and the synergy of integrating functional and anatomical images with PET/CT offer substantial benefit in the diagnostic work-up of patients with clinical suspicion for LVV. A negative temporal artery biopsy, an ultrasonography without an arterial halo, or a MRI without aortic wall thickening or oedema do not exclude the presence of LVV and should therefore not exclude the use of18F-FDG PET/CT when LVV is clinically suspected. This overview further discusses the notion that there is substantial underdiagnosis of LVV. Late diagnosis of LVV may lead to surgery or angioplasty in occlusive forms and is often accompanied by serious aortic complications and a fatal outcome. In contrast to the American College of Rheumatology 1990 criteria for vasculitis, based on late LVV effects like arterial stenosis and/or occlusion,18F-FDG PET/CT sheds new light on the classification of giant cell arteritis (GCA) and Takayasu arteritis (TA). The combination of these observations makes the role of18F-FDG PET/CT in the assessment of patients suspected for having LVV promising.

scholarly journals Bilateral Vertebral Artery Vasculitis—A Rare Manifestation of Giant Cell Arteritis and a Difficult Diagnosis Made Possible by 2-[18F]FDG PET/CT

Diagnostics ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. 879
Author(s):  
Natasja Justesen ◽  
Michael Hansen ◽  
Mads Jensen ◽  
Oliver Klefter ◽  
Jane Brittain ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Temporal Artery ◽  
High Dose ◽  
Temporal Artery Biopsy ◽  
Glucocorticoid Treatment ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

: Giant cell arteritis (GCA) is the most common form of large vessel vasculitis. GCA is a medical and ophthalmological emergency, and rapid diagnosis and treatment with high-dose corticosteroids is critical in order to reduce the risk of stroke and sudden irreversible loss of vision. GCA can be difficult to diagnose due to insidious and unspecific symptoms—especially if typical superficial extracranial arteries are not affected. In these cases, verification of clinical diagnosis using temporal artery biopsy is not possible. This example illustrates the diagnostic value of hybrid imaging with 2-deoxy-2-[18F]fluoro-D-glucose positron emission tomography/computed tomography (2-[18F]FDG PET/CT), and the limitations of the temporal artery biopsy in bilateral vertebral GCA, causing transient ischemic attack in the visual cortex. In addition it indicates that inflammation in the artery wall can be visualized on 2-[18F]FDG PET/CT despite long term and ongoing high dose glucocorticoid treatment.

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

2017 ◽  
Vol 44 (13) ◽  
pp. 2274-2279 ◽  
Author(s):  
Hubert de Boysson ◽  
Anael Dumont ◽  
Eric Liozon ◽  
Marc Lambert ◽  
Jonathan Boutemy ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Ct Angiography ◽  
Fdg Pet ◽  
Large Vessel ◽  
Pet Ct ◽  
Fdg Pet Ct ◽  
Vessel Involvement

AB0597 FDG PET-CT versus Temporal Artery Biopsy in Patients Presenting with Gca/Pmr: A Retrospective Cross-Sectional Study

2014 ◽  
Vol 73 (Suppl 2) ◽  
pp. 1003.1-1003
Author(s):  
S.A. Just ◽  
R.A. Gildberg-Mortensen ◽  
R.A. Andreasen ◽  
N. Lomborg ◽  
M.B. Morillon ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Temporal Artery ◽  
Cross Sectional Study ◽  
Temporal Artery Biopsy ◽  
Sectional Study ◽  
Cross Sectional ◽  
Pet Ct ◽  
Fdg Pet Ct

Repetitive 18 F-FDG-PET/CT in patients with large-vessel giant-cell arteritis and controlled disease

2017 ◽  
Vol 46 ◽  
pp. 66-70 ◽  
Author(s):  
Hubert de Boysson ◽  
Nicolas Aide ◽  
Eric Liozon ◽  
Marc Lambert ◽  
Jean-Jacques Parienti ◽  
...  
Keyword(s):  
Giant Cell Arteritis ◽  
Giant Cell ◽  
Fdg Pet ◽  
Large Vessel ◽  
Pet Ct ◽  
Fdg Pet Ct

FRI0262 The Role of 18F-FDG-PET/CT in the Diagnosis and Follow-Up of Large Vessel Vasculitis

2015 ◽  
Vol 74 (Suppl 2) ◽  
pp. 519.2-519
Author(s):  
G. Pazzola ◽  
M. Casali ◽  
F. Muratore ◽  
N. Pipitone ◽  
L. Boiardi ◽  
...  
Keyword(s):  
Fdg Pet ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

scholarly journals The role of 18F-FDG PET/CT in the management of large-vessel vasculitis: applications and limitations in clinical practice

2012 ◽  
pp. 249-254
Author(s):  
Maria V. Mattoli ◽  
Giorgio Treglia ◽  
Lucia Leccisotti ◽  
Alessandro Giordano
Keyword(s):  
Clinical Practice ◽  
Fdg Pet ◽  
False Negative ◽  
Large Vessel Vasculitis ◽  
Large Vessel ◽  
Metabolic Imaging ◽  
Small Vessel Vasculitis ◽  
Pet Ct ◽  
18F Fdg ◽  
Fdg Pet Ct

Introduction: 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) plays a key role in oncology, and it is now being used increasingly to diagnose, characterize, and monitor disease activity in inflammatory disorders, including vasculitis. Unfortunately, its role in the management of vasculitis is still not well-defined, and clinicians are often unsure how this metabolic imaging technique should be used in these diseases, although its usefulness in diagnosing large-vessel vasculitis has been clearly demonstrated. Materials and methods: We reviewed the literature about the use of PET/CT in the management of vasculitis in an attempt to identify the applications and the limitations of this technique in clinical practice. Results and discussion: Our literature review revealed that 18F-FDG PET/CT is a useful tool for diagnosing vasculitis (especially when the symptoms of the disease are non-specific); guiding biopsy procedures (areas with high glucose consumption); evaluating disease extension; and monitoring treatment responses. The main limitations of this method are the relatively low spatial resolution of the tomograph, which can lead to false-negative results in the presence of small-vessel vasculitis, and risk of false positive results, especially those related to the presence of atherosclerosis and to post-treatment vascular remodeling.

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