PET/CT imaging in polymyalgia rheumatica: praepubic 18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis

Zdenek Rehak; Andrea Sprlakova-Pukova; Zbynek Bortlicek; Zdenek Fojtik; Tomas Kazda; Marek Joukal; Renata Koukalova; Jiri Vasina; Jana Eremiasova; Petr Nemec

doi:10.1515/raon-2017-0001

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PET/CT imaging in polymyalgia rheumatica: praepubic 18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis

Radiology and Oncology

Volume 51 (2017): Issue 1 (March 2017)

By: Zdenek Rehak, Andrea Sprlakova-Pukova, Zbynek Bortlicek, Zdenek Fojtik, Tomas Kazda, Marek Joukal, Renata Koukalova, Jiri Vasina, Jana Eremiasova and Petr Nemec

Open Access

|Jan 2017

Figures & Tables

Initial 18FDG-PET/CT examination of all 15 examined patients, showing transversal planes through maximal praepubic uptake. Visually detectable accumulation can be observed in all patients.

Control 18FDG-PET/CT examination showing corresponding transversal slices as in Figure 1. Compared with Figure 1, decrease or complete diminishment of 18FDG accumulation is observable in all patients.

Patients’ baseline characteristics

Characteristics	Numbers (%)n= 15 (100%)
Sex, n (%)
females	10 (66.7 %)
males	5 (33.3 %)
Age at the disease onset
median (min-max)	70 years (53-78)
Time to follow up exam
median (min-max)	8 months (3-49)

Nuclear medicine data at baseline and follow up examination

	Baselinemedian (min-max)	Follow upmedian (min-max)	p-valuemedian (min-max)
¹⁸F-FDG	366 MBq (327-434)	362 MBq (301-400)	0.271
Praepubic / liver ¹⁸F-FDG uptake	1.50 (1.12-2.15)	0.58 (0.35-0.99)	0.001

Changes in analysed laboratory parameters between baseline and follow up examination

	Baselinemedian (min-max)	Follow upmedian (min-max)	p-valuemedian (min-max)
CRP	57 mg/l (17-137)	3 mg/l (1-17)	0.001
FW	74 mm/hod (44-120)	16 mm/hod (5-40)	0.001

Imaging and laboratory results of all patients_ Reported baseline treatment was initiated several days after baseline PET/CT

No	Diseasestatus	Date of baseline(B) andfollow up (FU)examination	Time tocontrolexam(months)	B/FUpraepubicto liveruptake ratio	B/FU FW(mm/h)	B/FU CRP(mg/dL)	B/FUtreatment(mg/day)	B/ FU region of positivity ofother PMR areas (target-to-liver ratio)	B/FUvascularpositivity
1	R	11-18-2014	4.0	1.134	44	23	P 15	S 2.23, H 1.25, Scl 1.13, Isch1.45	no positivity
1	R	3-20-2015	4.0	0.576	16	1.4	P 5	H 1.11	no positivity
2	N	2-23-2010	48.7	1.234	120	49	P 15	S 1.65, H 1.24, Scl 1.24, Isch1.17, L 1.14	no positivity
2	N	3-15-2014	48.7	0.812	26	16.9	M 8	no positivity	no positivity
3	N	9-1-2014	3.2	2.148	120	137	P 60	S 1.87, Scl 1.45, H 2.31, Isch1.65, L 1.12, Th 1.14, C 1.24	no positivity
3	N	12-8-2014	3.2	0.992	35	16.7	P 10	S 1.36	no positivity
4	N	7-24-2010	6.1	1.891	120	56.8	P 40	S 1.78, Scl 1.54, H 1, Isch 2.21,L 1.08	no positivity
4	N	1-25-2011	6.1	0.345	30	5.7	P 2.5	no positivity	no positivity
5	N	3-13-2014	12.0	1.772	60	28.5	P 20	S 2.02, H 1.47, Scl 1.24, Isch2.02, L 1.23	V3/6
5	N	3-13-2015	12.0	0.987	7	1	P 0	no positivity	V1/6no positivity
6	N	10-14-2013	16.9	1.298	54	45	P 20	S1.78, H1.88, Scl 1.95, L 1.25,Isch 1.16	V1/6no positivity
6	N	3-13-2015	16.9	0.537	6	5.3	P 2.5	no positivity	no positivity
7	R	1-3-2014	13.1	1.302	77	78.3	M 16	S 1.78, H 1.87, Scl 1.35, Isch1.65, L 1.12	V4/6
7	R	2-6-2015	13.1	0.403	5	1.9	M 2	no positivity	no positivity
8	N	6-9-2012	33.1	1.835	50	76	P 30	S 2.21, H 2.16, Scl 1.8, Isch1.78, L 1.2	V4/6
8	N	3-13-2015	33.1	0.54	14	3.1	P 0	H 1.23	V2/6
9	N	6-3-2015	3.1	1.502	60	41.5	P 15	S 2.36, H 2.24, Scl 2.03, Isch2.04, C 1.11	no positivity
9	N	9-4-2015	3.1	0.76	16	13.4	P 10	no positivity	no positivityno positivity
10	N	1-8-2014	21.7	1.209	80	78.3	P 60	S 1.84, H1.78, Scl 1.69, Isch1.57, L 1.23	no positivityno positivity
10	N	10-30-2015	21.7	0.395	10	2.5	P 7.5	no positivity	no positivity
11	R	3-4-2015	8.1	1.546	62	16.5	M 48 +MTX 10/weekM 4 +	S 2.66, H 2.74, Scl 2.0, Isch1.72, C 1.47, L 1.48	V5/6
11	R	11-5-2015	8.1	0.811	30	3.3	MTX 10/week	H 1.14, C 1.08, S 1.11, Scl 1.07S 2.27, H 2.06, Scl 2.16, Isch	V3/6
12	N	2-6-2015	8.3	1.789	120	98.7	M 32	3.03, L 1.45	no positivity
12	N	10-16-2015	8.3	0.97	40	7.5	M 8	Scl 1.14, Isch 1.21	no positivity
13	N	1-23-2015	14	1.123	70	67.5	P 15	S 1.78, H 1.87, Scl 1.69, Isch1.57, L 1.24	no positivity
13	N	3-24-2016	14	0.441	6	1.4	P 5	no positivity	no positivityno positivity
14	N	9-16-2015	5.8	1.282	74	52	P 20	S 2.44, H 3.04, Scl 2.07, L 1.21	no positivityno positivity
14	N	3-9-2016	5.8	0.41	24	3.2	P 7.5	no positivity	no positivity
15	N	10-26-2015	3.2	1.892	80	118.8	P 30	S 2.93, H 2.97, Isch 3.22, C1.44, L 1.24, Th 1.17, Scl 1.79	V4/6
15	N	2-1-2016	3.2	0.678	5	1.3	P20	no positivity	no positivity

References

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Articles in this issue

DOI: https://doi.org/10.1515/raon-2017-0001 | Journal eISSN: 1581-3207 | Journal ISSN: 1318-2099

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Language: English

Page range: 8 - 14

Submitted on: Aug 29, 2016

Accepted on: Dec 14, 2016

Published on: Jan 14, 2017

Published by: Association of Radiology and Oncology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

positron emission tomography,

polymyalgia rheumatica,

Related subjects:

Haematology, oncology,

Radiology

© 2017 Zdenek Rehak, Andrea Sprlakova-Pukova, Zbynek Bortlicek, Zdenek Fojtik, Tomas Kazda, Marek Joukal, Renata Koukalova, Jiri Vasina, Jana Eremiasova, Petr Nemec, published by Association of Radiology and Oncology
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

Volume 51 (2017): Issue 1 (March 2017)