Vasculitis & polymyalgia rheumatica
Impact of previous glucocorticoid therapy on diagnostic accuracy of [18F] FDG PET-CT in giant cell arteritis
Authors' conclusion
A late 18F-FDG PET-CT (beyond the first 10 days of treatment) can also be informative in a considerable percentage of cases.
Study context
- Population
- Patients with proven giant cell arteritis (GCA) who received high-dose glucocorticoid (GC) before 18F-FDG PET-CTconsecutive cohort
- Participants
- 85 patients
- Exposure
- PET-CT positivity by type, dose and duration of prior GC therapy
- Methylprednisolone (MP) bolusesn = 39
- Outcome
- Diagnostic accuracy (positivity) of 18F-FDG PET-CT after prior GC treatment
Methodological detailsconsecutive cohort
- Consecutive cohort
Main finding
As reported in the abstract
PET-CT positivity (uptake grade 3 or 2)
| Group | Value | MP 125 mg | MP 250 or 500 mg | MP 1 g | Treated <2 weeks | Treated 2 to 4 weeks | Treated 4 to 6 weeks |
|---|---|---|---|---|---|---|---|
| MP boluses | 37% | 80% | 33% | 0% | |||
| New-onset GCA, high-dose oral GC | 54.5% | 38.5% | 25% | ||||
| Relapsing/refractory GCA or prior PMR | 54% |
Value
MP boluses37%
New-onset GCA, high-dose oral GC— not stated in the abstract
Relapsing/refractory GCA or prior PMR54%
MP 125 mg
MP boluses80%
New-onset GCA, high-dose oral GC— not stated in the abstract
Relapsing/refractory GCA or prior PMR— not stated in the abstract
MP 250 or 500 mg
MP boluses33%
New-onset GCA, high-dose oral GC— not stated in the abstract
Relapsing/refractory GCA or prior PMR— not stated in the abstract
MP 1 g
MP boluses0%
New-onset GCA, high-dose oral GC— not stated in the abstract
Relapsing/refractory GCA or prior PMR— not stated in the abstract
Treated <2 weeks
MP boluses— not stated in the abstract
New-onset GCA, high-dose oral GC54.5%
Relapsing/refractory GCA or prior PMR— not stated in the abstract
Treated 2 to 4 weeks
MP boluses— not stated in the abstract
New-onset GCA, high-dose oral GC38.5%
Relapsing/refractory GCA or prior PMR— not stated in the abstract
Treated 4 to 6 weeks
MP boluses— not stated in the abstract
New-onset GCA, high-dose oral GC25%
Relapsing/refractory GCA or prior PMR— not stated in the abstract
Observational data: associations, not effects.
Further findings
PET-CT positivity including grade 1 uptake (circumferential, smooth linear or long segmental pattern), prior MP boluses
- All MP doses
- 62%
- MP 125 mg
- 100%
- MP 250 or 500 mg
- 50-60%
- MP 1 g
- 33%
- Grade 1 uptake possibly indicative of "apparently inactive" vasculitis
PET-CT positivity including grade 1 uptake, new-onset GCA on high-dose oral GC, by treatment duration
- <2 weeks
- 91%
- 2 to 4 weeks
- 77%
- 4 to 6 weeks
- 50%
PET-CT positivity including grade 1 uptake, relapsing/refractory GCA or GCA with prior PMR, on long-term low-to-moderate dose GC
- Relapsing/refractory GCA or prior PMR
- 68%
Original publication
Impact of previous glucocorticoid therapy on diagnostic accuracy of [18F] FDG PET-CT in giant cell arteritis. Semin Arthritis Rheum. Published 18 February 2023. doi:10.
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