ACR Meeting Abstracts

ACR Meeting Abstracts

  • Home
  • Meetings Archive
    • ACR Convergence 2020
    • 2020 ACR/ARP PRSYM
    • 2019 ACR/ARP Annual Meeting
    • 2018 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP Annual Meeting
    • 2017 ACR/ARHP PRSYM
    • 2016-2009 Meetings
    • Download Abstracts
  • Keyword Index
  • Advanced Search
  • Your Favorites
    • Favorites
    • Login
    • Register
    • View and print all favorites
    • Clear all your favorites
  • Meeting Resource Center

Abstract Number: 2196

Kinetics of Tissue-Specific Distribution of 18f-Fluorodeoxyglucose in Positron Emission Tomography in Large Vessel Vasculitis

Joel S. Rosenblum1, Kaitlin Quinn2, Mark A. Ahlman3 and Peter C. Grayson4, 1NIAMS, National Institute of Arthritis, Musculoskeletal and Skin Disease (NIAMS), Bethesda, MD, 2Systemic Autoimmunity Branch, NIAMS, Bethesda, MD, 3Radiology and Imaging Sciences, National Institutes of Health, Bethesda, MD, 4National Institute of Arthritis, Musculoskeletal and Skin Disease, National Institutes of Health, Bethesda, MD

Meeting: 2018 ACR/ARHP Annual Meeting

Keywords: giant cell arteritis, large vessel vasculitis, Magnetic resonance imaging (MRI), positron emission tomography (PET) and takayasu arteritis

  • Tweet
  • Email
  • Print
Save to PDF
Session Information

Date: Tuesday, October 23, 2018

Session Title: Imaging of Rheumatic Diseases Poster III: Other Modalities

Session Type: ACR Poster Session C

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

Background/Purpose: 18F-fluorodeoxyglucose (FDG) PET may be used to quantify vascular inflammation in large-vessel vasculitis (LVV).  Quantitative analysis of arterial FDG uptake has not been standardized. Delayed acquisition time may be advantageous for vascular PET imaging but has not been studied in LVV. Arterial FDG uptake is often normalized to uptake in background tissue; however, the factors that influence tissue-specific distribution of FDG in inflammatory diseases are unknown. The study objective was to identify factors associated with FDG uptake in 1) the large arteries and 2) background tissues (liver, blood pool, spleen) at 1 and 2 hour image acquisition times in a cohort of patients with LVV and comparators.

Methods: Patients with LVV and comparators (systemic inflammatory diseases, healthy controls), were recruited into a prospective observational cohort. Participants underwent either whole body PET-MR at 1 hour acquisition time, PET-CT at 2 hour acquisition time, or both. Arterial uptake was quantified as the sum of mean standardized uptake values (SUV)max  for 5 segments of the aorta, carotid, and subclavian arteries. SUVmean values were calculated for each background tissue. Multivariate linear regression models were used to identify associations between tissue-specific FDG uptake and atherosclerosis, vasculitis, and FDG clearance- related factors (see Table). The same predictor variables were included in each regression model to facilitate comparisons across different tissues. A p value < 0.05 was considered significant.

Results: PET scans were performed at 1 hour (n = 175) and 2 hours (n = 194), with most studies performed sequentially at both time points (n = 145).  Age, BMI, and CRP were significantly associated with arterial-FDG uptake at both the 1 and 2 hour time points, with increased effect estimates at 2 hours. Additional vasculitis-related factors (diagnosis, treatment) were also significantly associated with arterial uptake at the 2 hour time point. Factors related to FDG clearance (uptake time, glomerular filtration rate) were significantly associated with FDG uptake in liver and blood pool at 1 hour but were weakly or not associated with FDG uptake at 2 hours. Additional factors were associated with liver and blood pool at 2 hours, but with small effects estimate sizes. Vasculitis-related factors were associated with splenic uptake at 1 and 2 hours.

Conclusion: Tissue-specific factors are associated with FDG distribution in a time-dependent manner. Delayed image acquisition demonstrates stronger associations between arterial FDG uptake and atherosclerosis/vasculitis related factors. The impact of factors related to FDG clearance in background tissues is reduced with delayed imaging. Delayed image acquisition and normalization of arterial FDG uptake to liver or vein is preferable in LVV.

Table: Factors significantly associated with tissue distribution of 18f-fluorodeoxyglucose on positron emission tomography in large-vessel vasculitis at 1 and 2 hour imaging acquisition times

1-hour

Positron Emission Tomography

2-hour

Positron Emission Tomography

Target Tissue

Artery

Age (ß =0.09, p<0.01)

BMI (ß=0.28, p<0.01)

CRP (ß=0.05, p<0.01)

Age (ß=0.20, p<0.01)

BMI (ß=0.41, p<0.01)

CRP (ß=0.12, p=0.01)

Diagnosis (ß=2.06, p=0.04)

Immune Meds (ß=1.65, p=0.01)

Background Tissue

Liver

BMI (ß=0.02, p<0.01)

GFR (ß=-0.002, p=0.03)

Uptake time (ß=-0.003, p=0.01)

BMI (ß=0.03, p<0.01)

Age (ß=0.004, p=0.02)

Female (ß=0.08, p<0.01)

Blood

Pool

BMI (ß=0.01, p<0.01)

Uptake time (ß=-0.005, p<0.01)

GFR (ß=-0.003, p<0.01)

BMI (ß=0.02, p<0.01)

Uptake time (ß=-0.003, p<0.01)

Age (ß=0.004, p<0.01)

Fasting Glucose (ß=0.003, p<0.01)

Immune Meds (ß=-0.003, p<0.01)

Spleen

BMI (ß=0.02, p<0.01)

Diagnosis (ß=-0.08, p=0.03)

PGA (ß=-0.03, p=0.04)

WBC (ß=0.02, p<0.01)

BMI (ß=0.03, p<0.01)

Immune Meds (ß=-0.09, p=0.01)

*All of the following variables were included in each regression model:

Atherosclerosis-related factors: Gender (male vs female), Body mass index (BMI), Age in

years, Fasting glucose (mg/dL)

Vasculitis-related factors: C-reactive protein (CRP, mg/L), Total white blood cell count (WBC, K/uL), Treatment with immunosuppressants (Immune Meds, Yes vs No), Daily prednisone dose (mg), Physician global assessment (PGA, 0-10 scale), Diagnosis (large-vessel vasculitis vs comparator), Hematocrit (%)

FDG clearance factors: Uptake time (minutes from injection of FDG), Glomerular filtration rate (GFR, ml/minute)


Disclosure: J. S. Rosenblum, None; K. Quinn, None; M. A. Ahlman, None; P. C. Grayson, None.

To cite this abstract in AMA style:

Rosenblum JS, Quinn K, Ahlman MA, Grayson PC. Kinetics of Tissue-Specific Distribution of 18f-Fluorodeoxyglucose in Positron Emission Tomography in Large Vessel Vasculitis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10). https://acrabstracts.org/abstract/kinetics-of-tissue-specific-distribution-of-18f-fluorodeoxyglucose-in-positron-emission-tomography-in-large-vessel-vasculitis/. Accessed April 13, 2021.
  • Tweet
  • Email
  • Print
Save to PDF

« Back to 2018 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/kinetics-of-tissue-specific-distribution-of-18f-fluorodeoxyglucose-in-positron-emission-tomography-in-large-vessel-vasculitis/

Advanced Search

Your Favorites

You can save and print a list of your favorite abstracts by clicking the “Favorite” button at the bottom of any abstract. View your favorites »

ACR Convergence: Where Rheumatology Meets. All Virtual. November 5-9.

ACR Pediatric Rheumatology Symposium 2020

© COPYRIGHT 2021 AMERICAN COLLEGE OF RHEUMATOLOGY

Wiley

  • Home
  • Meetings Archive
  • Advanced Search
  • Meeting Resource Center
  • Online Journal
  • Privacy Policy
  • Permissions Policies
loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.