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Abstract Number: 1968

Distinct Distribution Patterns of Large Vessel Vasculitis Assessed with 18f-FDG PET/CT: Evidence from Principal Component and Cluster Analyses

Alessandra Soriano1, Giulia Pazzola1, Pierluigi Boiardi1, Francesco Muratore1, Pierluigi Macchioni1, Raffaella Aldigeri2, Massimiliano Casali3, Annibale Versari3 and Carlo Salvarani1,4, 1Rheumatology Unit, Internal Medicine Department, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy, 2Department of Clinical and Experimental Medicine, University of Parma, Parma, Italy, 3Nuclear Medicine Unit, Arcispedale Santa Maria Nuova - IRCCS, Reggio Emilia, Italy, 4Rheumatology Unit, Internal Medicine Department, Arcispedale Santa Maria Nuova - IRCCS, and University of Modena and Reggio Emilia, Reggio Emilia, Italy

Meeting: 2015 ACR/ARHP Annual Meeting

Date of first publication: September 29, 2015

Keywords: 18FDG PET/CT scan, Assessment, giant cell arteritis and large vessel vasculitis, Takayasu.s arteritis

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Session Information

Date: Monday, November 9, 2015

Title: Vasculitis Poster II

Session Type: ACR Poster Session B

Session Time: 9:00AM-11:00AM

Background/Purpose:

The performance of 18F-FDG PET/CT in the diagnosis and assessment of disease activity of LVV has not been fully established. The interpretation of data from 18F-FDG PET/CT studies on LVV is difficult mainly due to (1) the scarcity of studies; (2) the heterogeneity of the LVV populations examined in each study; (3) the variety in the qualitative and semi-quantitative methods for imaging analyses. In the absence of gold standard parameters for the assessment of LVV arterial inflammation via 18F-FDG PET/CT, there is a great need to develop analytical methodologies useful to properly exploit the information derived from such studies.

Latent class analysis has recently been used to investigate alternative ways to classify LVV in few angiographic and MRI studies, on the basis of distribution patterns of arterial lesions. Other classical techniques – such as principal component analysis (PCA) and cluster analysis (CA) – have not yet been applied to investigate the distribution patterns of LVV, assessed by 18F-FDG PET/CT.

The aim of our study was to investigate whether PCA and CA are useful methods in identifying distinct distribution patterns of LVV, according to the specific diagnostic entity examined (giant cell arteritis, GCA; Takayasu’s arteritis, TA).

Methods:

A total of 135 18F-FDG PET/CT studies performed for extra-cranial evaluation of LVV have been retrospectively examined by a nuclear physician blinded to clinical data. Maximum standardized uptake values (SUVmax) in 14 vascular districts including aortic segments (ascending aorta thoracic aorta, aortic arch, descending thoracic aorta and abdominal aorta) and the main tributaries (carotid, subclavian, axillary, iliac and femoral arteries; each bilaterally) have been measured and then transformed into Z-scores. Identification of distribution patterns of vascular involvement has been performed using PCA and agglomerative hierarchical CA (SPSS Statistics, version 22nd).

Results:

PCA and CA performed on the entire population of LVV subjects identified 3 groups of vascular districts with similar trends in terms of standardized SUVmax: (1) epiaortic arteries; (2) aortic arch and ascending aorta; (3) descending and abdominal aorta, together with iliac and femoral arteries. The same aggregation pattern has been observed in the PCA and CA performed on the GCA group, but not on the TA group, where a component including the entire aortic district (thoracic and abdominal aorta) was identified.

Conclusion:

PCA and cluster analysis approach revealed a subtle skewing in terms of distribution patterns of arterial involvement between the two main variants of LVV, assessed by 18F-FDG PET/CT SUVmax values. The influence of atherosclerosis and immunosenescence on the different trends in the aorta districts of TA and GCA needs to be further elucidated. 

References

Grayson PC, et al. Distribution of arterial lesions in Takayasu’s arteritis and giant cell arteritis. Ann Rheum Dis 2012;71:1329-1334.

Arnaud L, et al. Cluster analysis of arterial involvement in Takayasu arteritis reveals symmetric extension of the lesions in paired arterial beds. Arthritis Rheum 2011;63:1136-40.


Disclosure: A. Soriano, None; G. Pazzola, None; P. Boiardi, None; F. Muratore, None; P. Macchioni, None; R. Aldigeri, None; M. Casali, None; A. Versari, None; C. Salvarani, None.

To cite this abstract in AMA style:

Soriano A, Pazzola G, Boiardi P, Muratore F, Macchioni P, Aldigeri R, Casali M, Versari A, Salvarani C. Distinct Distribution Patterns of Large Vessel Vasculitis Assessed with 18f-FDG PET/CT: Evidence from Principal Component and Cluster Analyses [abstract]. Arthritis Rheumatol. 2015; 67 (suppl 10). https://acrabstracts.org/abstract/distinct-distribution-patterns-of-large-vessel-vasculitis-assessed-with-18f-fdg-petct-evidence-from-principal-component-and-cluster-analyses/. Accessed .
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