Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis
BackgroundA positive PET scan at diagnosis was associated with a greater yearly increase in ascending and descending aortic diameter and thoracic aortic volume in patients with giant cell arteritis (GCA). Radiologic and histopathologic vascular abnormalities persist in a subset of treated patients d...
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| Format: | Article |
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Frontiers Media S.A.
2024-03-01
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| Series: | Frontiers in Medicine |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2024.1384533/full |
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| author | Daniel Blockmans Daniel Blockmans Daniel Blockmans Lien Moreel Lien Moreel Albrecht Betrains Albrecht Betrains Steven Vanderschueren Steven Vanderschueren Steven Vanderschueren Walter Coudyzer Lennert Boeckxstaens Lennert Boeckxstaens Koen Van Laere Koen Van Laere |
| author_facet | Daniel Blockmans Daniel Blockmans Daniel Blockmans Lien Moreel Lien Moreel Albrecht Betrains Albrecht Betrains Steven Vanderschueren Steven Vanderschueren Steven Vanderschueren Walter Coudyzer Lennert Boeckxstaens Lennert Boeckxstaens Koen Van Laere Koen Van Laere |
| author_sort | Daniel Blockmans |
| collection | DOAJ |
| description | BackgroundA positive PET scan at diagnosis was associated with a greater yearly increase in ascending and descending aortic diameter and thoracic aortic volume in patients with giant cell arteritis (GCA). Radiologic and histopathologic vascular abnormalities persist in a subset of treated patients despite clinical remission. The aim of this study was to evaluate the association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms.MethodsWe recently performed a prospective cohort study of 106 GCA patients, who underwent FDG PET and CT imaging at diagnosis and CT imaging yearly for a maximum of 10 years. In this post hoc analysis, GCA patients who also have had FDG PET imaging during follow-up were included. PET scans were visually scored (0–3) at 7 vascular areas. PET scans were considered positive in case of FDG uptake ≥grade 2 in any large vessel.ResultsEighty-eight repeat PET scans were performed in 52 out of 106 GCA patients, who were included in the original prospective cohort. Fifty-five (63%) PET scans were done at the time of a relapse and 33 (38%) were done while in remission. Nine out of ten patients with an incident thoracic aortic aneurysm had both a positive PET scan at diagnosis and during follow-up.ConclusionIn addition to the intensity and extent of the initial vascular inflammation, ongoing aortic inflammation may contribute to the development of thoracic aortic aneurysms in GCA. However, this hypothesis should be confirmed in a large prospective trial with repeat PET scans at predefined time points during follow-up. |
| first_indexed | 2024-04-24T22:22:15Z |
| format | Article |
| id | doaj.art-3163642f0c7f441d9036caf939b27c41 |
| institution | Directory Open Access Journal |
| issn | 2296-858X |
| language | English |
| last_indexed | 2024-04-24T22:22:15Z |
| publishDate | 2024-03-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Medicine |
| spelling | doaj.art-3163642f0c7f441d9036caf939b27c412024-03-20T05:09:39ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2024-03-011110.3389/fmed.2024.13845331384533Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritisDaniel Blockmans0Daniel Blockmans1Daniel Blockmans2Lien Moreel3Lien Moreel4Albrecht Betrains5Albrecht Betrains6Steven Vanderschueren7Steven Vanderschueren8Steven Vanderschueren9Walter Coudyzer10Lennert Boeckxstaens11Lennert Boeckxstaens12Koen Van Laere13Koen Van Laere14Department of General Internal Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumEuropean Reference Network for Immunodeficiency, Autoinflammatory, Autoimmune and Pediatric Rheumatic Disease (ERN-RITA), Utrecht, NetherlandsDepartment of General Internal Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumDepartment of General Internal Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumDepartment of General Internal Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, BelgiumEuropean Reference Network for Immunodeficiency, Autoinflammatory, Autoimmune and Pediatric Rheumatic Disease (ERN-RITA), Utrecht, NetherlandsDepartment of Radiology, University Hospitals Leuven, Leuven, BelgiumDivision of Nuclear Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, BelgiumDivision of Nuclear Medicine, University Hospitals Leuven, Leuven, BelgiumDepartment of Imaging and Pathology, Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, BelgiumBackgroundA positive PET scan at diagnosis was associated with a greater yearly increase in ascending and descending aortic diameter and thoracic aortic volume in patients with giant cell arteritis (GCA). Radiologic and histopathologic vascular abnormalities persist in a subset of treated patients despite clinical remission. The aim of this study was to evaluate the association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms.MethodsWe recently performed a prospective cohort study of 106 GCA patients, who underwent FDG PET and CT imaging at diagnosis and CT imaging yearly for a maximum of 10 years. In this post hoc analysis, GCA patients who also have had FDG PET imaging during follow-up were included. PET scans were visually scored (0–3) at 7 vascular areas. PET scans were considered positive in case of FDG uptake ≥grade 2 in any large vessel.ResultsEighty-eight repeat PET scans were performed in 52 out of 106 GCA patients, who were included in the original prospective cohort. Fifty-five (63%) PET scans were done at the time of a relapse and 33 (38%) were done while in remission. Nine out of ten patients with an incident thoracic aortic aneurysm had both a positive PET scan at diagnosis and during follow-up.ConclusionIn addition to the intensity and extent of the initial vascular inflammation, ongoing aortic inflammation may contribute to the development of thoracic aortic aneurysms in GCA. However, this hypothesis should be confirmed in a large prospective trial with repeat PET scans at predefined time points during follow-up.https://www.frontiersin.org/articles/10.3389/fmed.2024.1384533/fullgiant cell arteritis (GCA)PETaortaaneurysmvasculitis |
| spellingShingle | Daniel Blockmans Daniel Blockmans Daniel Blockmans Lien Moreel Lien Moreel Albrecht Betrains Albrecht Betrains Steven Vanderschueren Steven Vanderschueren Steven Vanderschueren Walter Coudyzer Lennert Boeckxstaens Lennert Boeckxstaens Koen Van Laere Koen Van Laere Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis Frontiers in Medicine giant cell arteritis (GCA) PET aorta aneurysm vasculitis |
| title | Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis |
| title_full | Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis |
| title_fullStr | Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis |
| title_full_unstemmed | Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis |
| title_short | Association between vascular FDG uptake during follow-up and the development of thoracic aortic aneurysms in giant cell arteritis |
| title_sort | association between vascular fdg uptake during follow up and the development of thoracic aortic aneurysms in giant cell arteritis |
| topic | giant cell arteritis (GCA) PET aorta aneurysm vasculitis |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2024.1384533/full |
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