[18F]FDG-PET of giant-cell aortitis

M. A. Walter, R. A. Melzer1, M. Graf2, A. Tyndall1, J. Müller-Brand and E. U. Nitzsche

Institute of Nuclear Medicine, University Hospital Basel, 1 Division of Rheumatology, University Hospital Basel and 2 Institute of Clinical Pathology and Cytology, Basel, Switzerland

Correspondence to: M. A. Walter, Institute of Nuclear Medicine, University Hospital, Petersgraben 4, CH-4031 Basel, Switzerland. E-mail: m.a.walter{at}gmx.net

SIR, A 74-yr-old woman was admitted to hospital with a 6-month history of weakness, decreasing appetite, vomiting, abdominal pain and weight loss of 14 kg. Laboratory studies showed that the white cell count was 12 100/mm3, the haemoglobin concentration was 9.4 g/dl, the haematocrit was 29.1%, the platelet count was 494 000/mm3 and the C-reactive protein was 141 mg/l. Gastroscopy, colonoscopy and CT scanning showed no abnormalities.

For further evaluation, the patient was admitted for [18F]FDG-PET, which clearly demonstrated pathologically elevated glucose uptake within the vessel wall of the whole aorta (Fig. 1A, arrow) and its main thoracic and abdominal branches. The diagnosis of large-vessel vasculitis was subsequently confirmed by the finding of giant cell infiltration (Fig. 1B, arrow) with thickening of all temporal artery layers and consecutive stenosis of the lumen. The patient was treated with prednisone and recovery was unremarkable.



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FIG. 1. FDG-PET of a giant cell arteritis patient, which clearly demonstrates pathologically elevated glucose uptake within the vessel wall of the whole aorta (arrow).

 


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FIG. 1. Histological confirmation of giant cell arteritis, by finding of giant cell infiltration (arrow) with thickening of all temporal artery layers and consecutive stenosis of the lumen.

 
Due to its high sensitivity, especially in the state of active inflammation [1], [18F]FDG-PET might become a valuable diagnostic tool in the management of large-vessel inflammation.

The authors have declared no conflicts of interest.

References

  1. Webb M, Chambers A, Al-Nahhas A et al. The role of 18F-FDG PET in characterising disease activity in Takayasu arteritis. Eur J Nucl Med Mol Imaging 2004;31:627–34[CrossRef][ISI][Medline]
Accepted 21 December 2004





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