• Lien Moreel, Walter Coudyzer, Lennert Boeckxstaens, Albrecht Betrains, Geert Molenberghs, Steven Vanderschueren, Eveline Claus, Koen Van Laere, and Daniel Blockmans.
• Department of General Internal Medicine, University Hospitals Leuven, and Department of Microbiology, Immunology, and Transplantation, KU Leuven, Leuven, Belgium (L.M., A.B.).
• Ann. Intern. Med. 2023 Oct 1; 176 (10): 132113291321-1329.

BackgroundPrevious studies have shown that patients with giant cell arteritis (GCA) who have vascular 18F-fluorodeoxyglucose (FDG) uptake at diagnosis are at increased risk for thoracic aortic complications.ObjectiveTo measure the association between vascular FDG uptake at diagnosis and the change in aortic dimensions.DesignProspective cohort study.SettingUniversity Hospitals Leuven.Patients106 patients with GCA and FDG positron emission tomography (PET) imaging 3 days or less after initiation of glucocorticoids.MeasurementsPatients had PET and computed tomography (CT) imaging at diagnosis and CT imaging yearly for a maximum of 10 years. The PET scans were scored 0 to 3 in 7 vascular areas and summed to a total vascular score (TVS). The PET scan results were positive when FDG uptake was grade 2 or greater in any large vessel. The association between vascular FDG uptake and aortic dimensions was estimated by linear mixed-effects models with random intercept and slope.ResultsWhen compared with patients with a negative PET scan result, those with a positive scan result had a greater increase in the diameter of the ascending aorta (difference in 5-year progression, 1.58 mm [95% CI, 0.41 to 2.74 mm]), the diameter of the descending aorta (1.32 mm [CI, 0.38 to 2.26 mm]), and the volume of the thoracic aorta (20.5 cm³ [CI, 4.5 to 36.5 cm³]). These thoracic aortic dimensions were also positively associated with TVS. Patients with a positive PET scan result had a higher risk for thoracic aortic aneurysms (adjusted hazard ratio, 10.21 [CI, 1.25 to 83.3]).LimitationThe lengthy inclusion and follow-up period resulted in missing data and the use of different PET machines.ConclusionHigher TVS was associated with greater yearly increase in thoracic aortic dimensions. Performing PET imaging at diagnosis may help to estimate the risk for aortic aneurysm formation.Primary Funding SourceNone.

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