ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 260

Use of Positron Emission Tomography for the Diagnosis of Aortitis. a Study of 170 Patients from a Single Center

Lucia C. Domínguez-Casas1, Javier Loricera1, Diana Prieto Peña1, Isabel Martínez-Rodríguez2, Jose Ignacio Banzo2, Monica Calderón Goercke1, Vanesa Calvo-Río1, Nuria Vegas-Revenga1, MC Gonzalez-Vela3, Jesus Gonzalez- Vela4, José Luis Martín-Varillas1, Belén Atienza-Mateo1, Jose L. Hernández5, Miguel Angel González-Gay1 and Ricardo Blanco1, 1Rheumatology, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 2Nuclear Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 3Pathology Anatomy, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 4Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain, 5Internal Medicine, Hospital Universitario Marqués de Valdecilla. IDIVAL. Santander. Universidad de Cantabria. Spain, Santander, Spain

Meeting: 2017 ACR/ARHP Annual Meeting

Date of first publication: September 18, 2017

Keywords:

Session Information

Date: Sunday, November 5, 2017

Title: Imaging of Rheumatic Diseases Poster I

Session Type: ACR Poster Session A

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

Background/Purpose:

Aortitis is the inflammation of the aortic wall. This entity is often under-recognised because most of its manifestations are non-specific. PET/CT scan plays an important role in the diagnosis and management of aortitis; however this technique is expensive.

Our aim was to compare the baseline characteristics of patients with a suspicion of aortitis and positive results on PET/CT scan and those with a negative result in order to search for predictive factors that improve the clinical probability of diagnosis aortitis by this imaging technique.

Methods:

Retrospective study on 170 patients and PET/CT scans ordered by suspicion of aortitis from a referral center from January 2010 to December 2016. According to a pre-specified protocol, the baseline epidemiological and clinical variables of patients with positive and negative PET/CT scans results for aortitis were reviewed. Distributions of categorical variables were compared by the Pearson Chi2 or Fisher exact test. Quantitative variables were analyzing using the Student t test or Mann-Whitney U test as appropriate.

Results:

In 170 patients, PET/CT scans were performed due to clinical suspicion of aortitis, being positive in 93 (54.7%) cases. Patients (113W/57M) had a mean age of 67.7±13.1 years (range, 20-90 years). One patient was excluded because missing clinical or laboratory data.

The underlying conditions at the momento of orderinf the PET/CT scan were: giant cell arteritis (GCA) (n=28), spondiloarthropaties (n=7), conectivopaties (n=6), Takayasu arteritis (n=3), ulcerative colitis (n=3), other condition (n=11) The remaining 111 patiens dud not hace any underlying condition suggestive of aortitis.

Characteristics of patients with positive and negative PET/CT sacan were shown in the Table. Patients with GCA had a higher percentage of positive PET/CT scans, whereas the were negative more frequently in patients who did not have any conidition suggestive of underlying aortitis. Only inflammatory low back pain and polymyalgic syndrome were significantly more frequent in patients with positives PET/CT scans.

Conclusion:

In this study, we have found the presence of inflammatory low back pain and polymyalgic syndrome, especially in GCA patients, may have clinical relevance in ordering a PET/CT scan when aortitis was suspected.

TABLE

Positive PET

n= 92

Negative PET

n= 77

p

Age (years), mean±SD

67.4± 11.1

68.1±15.2

0.73

Age ≥ 70 years, n (%)

39 (41.9)

41 (53.2)

0.14

Sex (women), n (%)

62 (67.4)

54 (70.1)

0.63

Underlying condition

  • Giant cell arteritis, n (%)

24 (26.1)

4 (5.2)

0.0002

  • Takayasu arteritis, n (%)

3 (3.3)

0 (0)

0.31

  • Ulcerative colitis, n (%)

2 (2.2)

1 (1.3)

0.87

  • Conectivopaties, n (%)

3 (3.3)

3 (3.9)

0.86

  • Spondiloarthropaties, n (%)

3 (3.3)

4 (5.2)

0.79

  • None, n (%)

54 (58.7)

57 (74.0)

0.03

  • Other, n (%)

3 (3.3)

8 (10.4)

0.11

Symptoms at the time of requesting PET

  • Constitutional syndrome, n (%)

30 (32.6)

36 (46.8)

0.06

  • Fever, n (%)

18 (19.6)

15 (19.5)

0.98

  • Inflammatory low back pain, n (%)

30 (32.6)

14 (18.2)

0.03

  • Diffuse lower limbs pain, n (%)

42 (45.7)

28 (36.4)

0.22

  • Atypical polymyalgia rheumatica, n (%)

30 (53.6)

13 (38.2)

0.15

  • Headache, n (%)

18 (19.6)

9 (11.7)

0.16

  • Polymialgic syndrome, n (%)

56 (60.9)

34 (44.2)

0.03

Laboratory markers at the time of requesting PET

  • Anaemia, n (%)

18 (20.2)

22 (28.9)

0.19

  • ESR (mm/1ªh), mean±SD

43.3±34.3

43.5±31.1

0.72

  • CRP (mg/dl), median [IQR]

0.9 [0.3-2.6]

0.9 [0.3-2.5]

0.54

Treatment at the time of requesting PET

  • Patients with corticosteroids, n (%)

48 (51.6)

36 (46.8)

0.48

  • Dosage of prednisone (mg), median [IQR]

10 [5-15]

10 [7.5-15]

0.80

  • Patients with traditional immunosuppressants, n (%)

11 (12.0)

5 (6.5)

0.21


Disclosure: L. C. Domínguez-Casas, None; J. Loricera, None; D. Prieto Peña, None; I. Martínez-Rodríguez, None; J. I. Banzo, None; M. Calderón Goercke, None; V. Calvo-Río, None; N. Vegas-Revenga, None; M. Gonzalez-Vela, None; J. Gonzalez- Vela, None; J. L. Martín-Varillas, None; B. Atienza-Mateo, None; J. L. Hernández, None; M. A. González-Gay, None; R. Blanco, None.

To cite this abstract in AMA style:

Domínguez-Casas LC, Loricera J, Prieto Peña D, Martínez-Rodríguez I, Banzo JI, Calderón Goercke M, Calvo-Río V, Vegas-Revenga N, Gonzalez-Vela M, Gonzalez- Vela J, Martín-Varillas JL, Atienza-Mateo B, Hernández JL, González-Gay MA, Blanco R. Use of Positron Emission Tomography for the Diagnosis of Aortitis. a Study of 170 Patients from a Single Center [abstract]. Arthritis Rheumatol. 2017; 69 (suppl 10). https://acrabstracts.org/abstract/use-of-positron-emission-tomography-for-the-diagnosis-of-aortitis-a-study-of-170-patients-from-a-single-center/. Accessed .

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