• Boramy Hay, Denis Mariano-Goulart, Aurélie Bourdon, Meriem Benkiran, Fabien Vauchot, Delphine De Verbizier, and Fayçal Ben Bouallègue.
• Nuclear Medicine Department, Montpellier University Hospital, Montpellier, France. boramy.hay@gmail.com.
• Ann Nucl Med. 2019 Jul 1; 33 (7): 512-520.

ObjectiveThe purpose of our study was to assess the diagnostic performance of 18F-FDG PET-CT for large vessel involvement in patients with suspected giant cells arteritis (GCA) and a negative temporal artery biopsy (TAB).MethodsWe conducted a retrospective study in a cohort of patients with suspected GCA and negative TAB who underwent an 18F-FDG PET-CT. Ten vascular segments were studied using a visual score and a semi-quantitative method based on SUVmax ratio with respect to liver uptake. The diagnosis of GCA was established during a mean follow-up of 42 months, based on the presence of clinical symptoms, laboratory results, and imaging data compatible with GCA, good response to corticosteroid therapy, and no differential diagnosis after a follow-up of at least 18 months.ResultsWe included 63 patients (30 men and 33 women, aged 67 ± 12 years). 18F-FDG PET-CT showed large vessel involvement in 22 patients, 14 of whom were finally diagnosed with GCA. Forty-one patients were 18F-FDG PET-CT negative, 9 of whom were finally diagnosed with GCA. Overall, 18F-FDG uptake by large vessel yielded 61% sensitivity, 80% specificity, 64% positive predictive value, 78% negative predictive value, and 73% diagnostic accuracy. A significant number of patients were treated by corticosteroids before 18F-FDG PET-CT. However, corticosteroid therapy did not impact significantly the diagnostic performance, although there was a trend to a lower sensitivity in patients receiving corticosteroid therapy for more than 3 days.Conclusions18F-FDG PET-CT is a useful imaging technique to assess large vessel involvement in patients with suspected GCA and negative TAB.

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