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PET assessment of disease activity in children with juvenile idiopathic arthritis

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Abstract

Background

The degree of 18-fluorodeoxyglucose (FDG) uptake is previously reported to correlate with physical examination and laboratory tests for evaluating disease activity in patients with rheumatoid arthritis. The clinical validity of 18F-FDG positron emission tomography (PET) has not been evaluated in juvenile idiopathic arthritis (JIA).

Objective

To assess the relationship between 18F-FDG PET uptake and disease activity in children with JIA.

Materials and methods

A total of 560 joints in 28 children (mean age, 5.4 years; range, 1–16 years) with JIA who had undergone whole-body 18F-FDG PET before treatment were retrospectively assessed clinically, biochemically and radiographically. PET images were assessed independently by two readers. We investigated the relationships between the degree of synovial 18F-FDG uptake and radiographic and clinical symptoms and laboratory findings.

Results

Joint tenderness and swelling had a positive association with abnormal 18F-FDG uptake in the joint [odds ratio (OR) 5.37, 7.12, respectively]. The standardized uptake value (SUV) max correlated with the neutrophil count, plasma C-reactive protein (CRP), erythrocyte sedimentation rate (ESR) and matrix metalloproteinase (MMP) 3. Joint erosion (OR, 6.17), soft-tissue swelling (OR, 3.77), major joints involvement (OR, 3.50), tenderness (OR, 5.22), and CRP concentration in plasma (OR, 1.81) were positively associated with SUVmax.

Conclusion

The degree of 18F-FDG uptake may be associated with the severity of synovitis in children with JIA.

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Acknowledgments

The authors thank Jin Lee, Hiroaki Hagiwara, Zenjiro Sekikawa, Keisuke Yoshida, Tomohiro Yoneyama, as well as Masashi Kawaguchi, the research staff of the study for their help with data collection. Gratitude is expressed to Akiko Suzuki, Ryogo Minamimoto and Hirofumi Shibata for their assistance with data analyses.

This work was supported in part by grants from Scientific Research Expenses for Health and Welfare Programs and the Grant-in-Aid for Cancer Research from the Ministry of Health, Labour and Welfare.

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Authors and Affiliations

  1. Department of Radiology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan

    Ukihide Tateishi, Noriko Kanezawa, Tetsuhiko Okabe, Kazuya Shizukuishi & Tomio Inoue

  2. Department of Pediatrics, Yokohama City University Graduate School of Medicine, Yokohama, Japan

    Tomoyuki Imagawa & Shumpei Yokota

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  1. Ukihide Tateishi
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  2. Tomoyuki Imagawa
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  3. Noriko Kanezawa
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  4. Tetsuhiko Okabe
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  5. Kazuya Shizukuishi
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  6. Tomio Inoue
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  7. Shumpei Yokota
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Correspondence to Ukihide Tateishi.

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Tateishi, U., Imagawa, T., Kanezawa, N. et al. PET assessment of disease activity in children with juvenile idiopathic arthritis. Pediatr Radiol 40, 1781–1788 (2010). https://doi.org/10.1007/s00247-010-1716-5

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  • DOI: https://doi.org/10.1007/s00247-010-1716-5

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