Clinical Implication of 18 F-FDG-PET in Diagnosing and Monitoring Disease Activity in a Case of Subclinical Stage of Giant Cell Arteritis

Su-Jin Yoo; Jeong Chan Lee; Young Kim; In Seol Yoo; Seung Cheol Shim; Kun-Ho Kim; Seong Wook Kang

doi:10.4078/jrd.2015.22.6.382

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Yoo, Lee, Kim, Yoo, Shim, Kim, and Kang: Clinical Implication of 18 F-FDG-PET in Diagnosing and Monitoring Disease Activity in a Case of Subclinical Stage of Giant Cell Arteritis

Case Report

J Rheum Dis 2015;22(6):382-386.

Published online: 31 October 2015

DOI: https://doi.org/10.4078/jrd.2015.22.6.382

Clinical Implication of ¹⁸ F-FDG-PET in Diagnosing and Monitoring Disease Activity in a Case of Subclinical Stage of Giant Cell Arteritis

Su-Jin Yoo¹, Jeong Chan Lee¹, Young Kim¹, In Seol Yoo¹, Seung Cheol Shim¹, Kun-Ho Kim², Seong Wook Kang¹

¹Department of Internal Medicine, Chungnam National University School of Medicine, Daejeon, Korea

²Department of Nuclear Medicine, Chungnam National University School of Medicine, Daejeon, Korea

Corresponding to: Seong Wook Kang, Department of Internal Medicine, Chungnam National University School of Medicine, 266 Munhwa-ro, Jung-gu, Daejeon 35015, Korea. E-mail: kangsw@cnuh.co.kr

Received 16 October 2014 Revised 26 January 2015 Revised 10 February 2015 Accepted 12 February 2015

This is a Free Access article, which permits unrestricted non-commerical use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Giant cell arteritis (GCA) is a systemic vasculitis which typically occurs in persons over 50 years old. GCA is closely related to polymyalgia rheumatica (PMR). A temporal artery biopsy is the gold standard test for the diagnosis of GCA. Recently, there is increasing evidence for the role of ¹⁸ F-fluorodeoxyglucose positron emission tomography (¹⁸ F-FDG-PET) in diagnosis of vasculitis. Here, we report on a case of a 67-year-old Korean male who was diagnosed with atypical GCA in subclinical stage concomitant with PMR by ¹⁸ F-FDG-PET. After treatment, abnormal findings of ¹⁸ F-FDG-PET were improved.

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Keywords: Giant cell arteritis, Polymyalgia rheumatica, Positron emission tomography

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Figure 1.

¹⁸ F-fluorodeoxyglucose positron emission tomography before treatment. There are increased glucose metabolism in the walls of the ascending aorta, aortic arch, thoracic descending aorta, both subclavian arteries, both common carotid arteries and especially both common femoral arteries and their large branches with wall thickening.

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Figure 2.

¹⁸ F-fluorodeoxyglucose positron emission tomography after 12 months of treatment. There is no metabolic evidence of arteritis.

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Figure 3.

¹⁸ F-fluorodeoxyglucose positron emission tomography images and aorta to liver maximal standardized uptake value ratio. (A) The aorta to liver ratio before treatment was 1.49 (thoracic aorta 3.45, liver 2.32). (B) The aorta to liver ratio after treatment was 0.98 (thoracic aorta 2.75, liver 2.80).

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