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

  • Hubert de Boysson
  • Anael Dumont
  • Eric Liozon
  • Marc Lambert
  • Jonathan Boutemy
  • Gwénola Maigné
  • Nicolas Martin Silva
  • Audrey Sultan
  • Kim Heang Ly
  • Nicolas Aide
  • Alain Manrique
  • Boris Bienvenu
  • Achille Aouba
Original Article

Abstract

Purpose

The purpose of our study was to assess the concordance of aortic CT angiography (CTA) and FDG-PET/CT in the detection of large-vessel involvement at diagnosis in patients with giant-cell arteritis (GCA).

Methods

We created a multicenter cohort of patients with GCA diagnosed between 2010 and 2015, and who underwent both FDG-PET/CT and aortic CTA before or in the first ten days following treatment introduction. Eight vascular segments were studied on each procedure. We calculated concordance between both imaging techniques in a per-patient and a per-segment analysis, using Cohen’s kappa concordance index.

Results

We included 28 patients (21/7 women/men, median age 67 [56–82]). Nineteen patients had large-vessel involvement on PET/CT and 18 of these patients also presented positive findings on CTA. In a per-segment analysis, a median of 5 [1–7] and 3 [1–6] vascular territories were involved on positive PET/CT and CTA, respectively (p = 0.03). In qualitative analysis, i.e., positivity of the procedure suggesting a large-vessel involvement, the concordance rate between both procedures was 0.85 [0.64–1]. In quantitative analysis, i.e., per-segment analysis in both procedures, the global concordance rate was 0.64 [0.54–0.75]. Using FDG-PET/CT as a reference, CTA showed excellent sensitivity (95%) and specificity (100%) in a per-patient analysis. In a per-segment analysis, sensitivity and specificity were 61% and 97.9%, respectively.

Conclusions

CTA and FDG-PET/CT were both able to detect large-vessel involvement in GCA with comparable results in a per-patient analysis. However, PET/CT showed higher performance in a per-segment analysis, especially in the detection of inflammation of the aorta’s branches.

Keywords

18FDG-pet/Ct CT angiography Giant-cell arteritis Large-vessel vasculitis 

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Copyright information

© Springer-Verlag GmbH Germany 2017

Authors and Affiliations

  • Hubert de Boysson
    • 1
  • Anael Dumont
    • 1
  • Eric Liozon
    • 2
  • Marc Lambert
    • 3
  • Jonathan Boutemy
    • 1
  • Gwénola Maigné
    • 1
  • Nicolas Martin Silva
    • 1
  • Audrey Sultan
    • 1
  • Kim Heang Ly
    • 2
  • Nicolas Aide
    • 4
    • 5
  • Alain Manrique
    • 4
    • 6
  • Boris Bienvenu
    • 1
  • Achille Aouba
    • 1
  1. 1.Department of Internal MedicineCaen University HospitalCaenFrance
  2. 2.Department of Internal MedicineLimoges University HospitalLimogesFrance
  3. 3.Department of Internal MedicineLille University HospitalLilleFrance
  4. 4.Department of Nuclear MedicineCaen University HospitalCaenFrance
  5. 5.INSERM U1086 “ANTICIPE”, François Baclesse Cancer CentreCaenFrance
  6. 6.Normandy UniversityCaenFrance

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