Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study.

Einspieler, Ingo; Thürmel, Klaus; Pyka, Thomas; Eiber, Matthias; Wolfram, Sabine; Moog, Philipp; Reeps, Christian; Essler, Markus

doi:10.1007/s00259-015-3007-8

2015

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Title:: Imaging large vessel vasculitis with fully integrated PET/MRI: a pilot study.
Document type:: Journal Article; 7
Author(s):: Einspieler, Ingo; Thürmel, Klaus; Pyka, Thomas; Eiber, Matthias; Wolfram, Sabine; Moog, Philipp; Reeps, Christian; Essler, Markus
Abstract:: The aim of this study was to evaluate the feasibility of hybrid [(18)F]fluorodeoxyglucose (FDG) positron emission tomography (PET)/MRI in patients with large vessel vasculitis (LVV) by comparing visual and quantitative parameters to that of PET/CT. Furthermore, the value of PET/MRI in disease activity and extent of LVV was assessed.A total of 16 [(18)F]FDG PET/MRI and 12 [(18)F]-FDG PET/CT examinations were performed in 12 patients with LVV. MRI of the vessel wall by T1-weighted and T2-weighted sequences was used for anatomical localization of FDG uptake and identification of morphological changes associated with LVV. In addition, contrast-enhanced (CE) magnetic resonance angiography (MRA) was performed. The vascular FDG uptake in the vasculitis group was compared to a reference group of 16 patients using a four-point visual score. Visual scores and quantitative parameters [maximum standardized uptake value (SUVmax) and target to background ratio (TBR)] were compared between PET/MRI and PET/CT. Furthermore, correlations between C-reactive protein (CRP) and quantitative PET results, as well the extent of vasculitis in PET, MRI/CE-MRA and combined PET/MRI, were analysed.TBRs, SUVmax values and visual scores correlated well between PET/MRI and PET/CT (r = 0.92, r = 0.91; r = 0.84, p < 0.05). There was no significant difference between both modalities concerning SUVmax measurements and visual scores. In PET/MRI, PET alone revealed abnormal FDG uptake in 86 vascular regions. MRI/CE-MRA indicated 49 vessel segments with morphological changes related to vasculitis, leading to a total number of 95 vasculitis regions in combination with PET. Strong and significant correlations between CRP and disease extent in PET alone (r = 0.75, p = 0.0067) and PET/MRI (r = 0.92, p < 0.0001) in contrast to MRI/CE-MRA only were observed. Regarding disease activity, no significant correlations were seen between quantitative PET results and CRP, although there was a trend towards significance (r = 0.55, p = 0.0651). PET/MRI also showed active LVV in 15/16 examinations.Hybrid PET/MRI is feasible in LVV and holds promise for precisely determining disease extent and disease activity.
Journal title abbreviation:: Eur J Nucl Med Mol Imaging
Year:: 2015
Journal volume:: 42
Journal issue:: 7
Pages contribution:: 1012-24
Language:: eng
Fulltext / DOI:: doi:10.1007/s00259-015-3007-8
Pubmed ID:: http://view.ncbi.nlm.nih.gov/pubmed/25876704
Print-ISSN:: 1619-7070
TUM Institution:: Fachgebiet Gefäßchirurgie (Prof. Eckstein); Fachgebiet Nephrologie (Prof. Heemann); Klinik und Poliklinik für Nuklearmedizin
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