Download PDF
Nuklearmedizin 2013; 52(06): 244-249
DOI: 10.3413/Nukmed-0597-13-06
Original article
Schattauer GmbH

Demonstrating disease activity in patients with rheumatoid arthritis

Is 18F FDG PET a sensitive method?Demonstration der Krankheitsaktivität bei Patienten mit rheumatoider Arthritis Ist 18F-FDG-PET eine empfindliche Methode?Ist 18F-FDG-PET eine empfindliche Methode?
I. Karapolat
1   Nuclear Medicine, Sifa University Medical Faculty, Izmir, Turkey
,
F. Sertpoyraz
2   Physical Medicine and Rehabilitation, Tepecik State Hospital, Izmir, Turkey
,
G. Oncel
3   Radiology, Sifa University Medical Faculty, Izmir, Turkey
,
S. Kobak
4   Department of Internal Medicine, Division of Rheumatology, Sifa University Medical Faculty, Izmir, Turkey
,
M. Yalcin
5   Internal Medicine, Sifa University Medical Faculty, Izmir, Turkey
,
K. Kumanlioglu
6   Nuclear Medicine, Ege University Medical Faculty, Izmir, Turkey
› Author Affiliations
Further Information

Publication History

received: 03 June 2013

accepted in revised form: 19 September 2013

Publication Date:
12 January 2018 (online)

Also available at
    Permissions and Reprints

Summary

Aim: We aimed to investigate the relationship of fluor-18 fluorodeoxyglucose positron emission tomography/computed tomography (18F FDG PET/CT) with clinical, laboratory parameters and conventional radiographs in patients with rheumatoid arthritis (RA). Patients, material, methods: 25 patients with RA diagnosis were evaluated by sociodemographic, clinical [duration of disease (year), the joints in which the complaints started, most recent joint involvement]; other parameters used in RA-specific clinical assessment [Steinbocker functional staging, disease activity score 28 (DAS 28 score), health assessment questionnaire score (HAQ score), general RA assessment (patients’ and physicians’ global assessment), patients’ assessments of pain and general health condition (visual analog scale)], laboratory, radiological [conventional radiology of hand and foot joints], positron emission tomography [18F FDG PET visual total score and maximum standardized uptake value (SUVmax) total score] parameters. Results: No significant correlation was detected between the 18F FDG PET total score and SUVmax total score of the patients and clinical, laboratory, and radiological parameters (p > 0.05). There was no relationship between the cut-off values determined according to the disease activity and 18F FDG PET/ SUVmax total values (p > 0.05). Conclusions: In our study, no relationship was found between disease activity demonstrated by 18F FDG PET/CT in RA patients and clinical, laboratory, and radiological parameters. 18F FDG PET/CT appears to be a more sensitive method in demonstrating disease activity compared to other evaluated methods.

Zusammenfassung

Ziel: Bei dieser Studie wurde die Beziehung der Klinik und Laborparameter mit der konventionellen Radiographie von 18F-FDG-PET/ CT bei Patienten mit rheumatoider Arthritis (RA) erforscht. Patienten, Material, Methode: Bei 25 Patienten mit der Diagnose RA wurden soziodemographische Daten, klinische Daten [Dauer der Erkrankung (in Jahren), Gelenke, bei denen die Beschwerden begannen, Gelenke, die zuletzt betroffen wurden], andere Parameter [Steinbocker funktionelle Kapazität, Punktzahl 28 der Erkrankungsaktivität (DAS-28-Score), die bei der klinischen Bewertung bei RA-Patienten angewandt werden, der Gesundheits-Auswertungsfragebogen HAQ-Score, die Daten der allgemeinen RABeurteilung (globale Beurteilung des Patienten und des Arztes); die Beurteilung der Schmerzen von seitens des Patienten (visuelle analoge Skala: 0 sehr gut – 10 sehr schlecht)], Laboratorium, Radiologie (konventionelle Radiographie der Hand und Fußgelenke) und die Daten der Positronenemissionstomographie (FDG PET totaler score und SUVmax totaler score) beurteilt. Ergebnisse: Zwischen PET- und SUVmax-Gesamt-Score, Klinik, Labor- und Radiologieparametern wurde keine bedeutsame Korrelation festgestellt (p > 0.05). Schlussfolgerung: Bei unserer Studie wurde zwischen 18F-FDG-PET/CT, dargestellter Erkrankungsaktivität von RA-Patienten Klinik, Labor- und Radiologieparametern keine bedeutsame Beziehung festgestellt. 18F-FDG-PET/CT scheint bei Patienten mit rheumatoider Arthritis zur Beurteilung der Erkrankungsaktivität eine sensiblere Methode zu sein als die anderen Methoden.

Keywords

18F FDG PET/CT - rheumatoid arthritis - disease activity - DAS 28 - SUVmax

Schlüsselwörter

18F FDG PET/CT - rheumatoide Arthritis - Krankheitsaktivität - DAS 28 - SUVmax
 

  • References

  • 1 Andersson I, Marsal L, Nilsson B. et al. Abnormal axillary lymph nodes in rheumatoid arthritis. Acta Radiol Diagn (Stockh) 1980; 21: 645-649.
    PubMedGoogle Scholar
  • 2 Arnett FC, Edworthy SM, Bloch DA. et al. The American Rheumatism Association 1987 revised criteria for the classification of rheumatoid arthritis. Arthritis Rheum 1988; 31: 315-324.
    CrossrefPubMedGoogle Scholar
  • 3 Backhaus M, Kamradt T, Sandrock D. et al. Arthritis of the finger joints: a comprehensive approach comparing conventional radiography, scintigraphy, ultrasound, and contrast-enhanced magnetic resonance imaging. Arthritis Rheum 1999; 42: 1232-1245.
    CrossrefPubMedGoogle Scholar
  • 4 Beckers C, Jeukens X, Ribbens C. et al. 18F-FDG PET imaging of rheumatoid knee synovitis correlates with dynamic magnetic resonance and sonographic assessments as well as with the serum level of metalloproteinase-3. Eur J Nucl Med Mol Imaging 2006; 33: 275-280.
    CrossrefPubMedGoogle Scholar
  • 5 Beckers C, Ribbens C, André B. et al. Assessment of disease activity in rheumatoid arthritis with 18F-FDG PET. J Nucl Med 2004; 45: 956-964.
    PubMedGoogle Scholar
  • 6 Boutry N, Morel M, Flipo RM. et al. Early rheumatoid arthritis: a review of MRI and sonographic findings. AJR Am J Roentgenol 2007; 189: 1502-1509.
    CrossrefPubMedGoogle Scholar
  • 7 Bresnihan B. Pathogenesis of joint damage in rheumatoid arthritis. J Rheumatol 1999; 26: 717-719.
    Google Scholar
  • 8 Calgüneri M, Oztürk MA, Ozbalkan Z. et al. Frequency of lymphadenopathy in rheumatoid arthritis and systemic lupus erythematosus. J Int Med Res 2003; 31: 345-349.
    CrossrefPubMedGoogle Scholar
  • 9 Dreher R. Origins of synovial type A cells during inflammation. Immunobiology 1982; 161: 232.
    CrossrefPubMedGoogle Scholar
  • 10 Forslind K, Ahlmen M, Eberhardt K. et al. Prediction of radiological outcome in early rheumatoid arthritis in clinical practice: role of antibodies to citrullinated peptides (anti-CCP). Ann Rheum Dis 2004; 63: 1090-1095.
    CrossrefPubMedGoogle Scholar
  • 11 Goerres GW, Forster A, Uebelhart D. et al. 18F FDG whole-body PET for the assessment of disease activity in patients with rheumatoid arthritis. Clin Nucl Med 2006; 31: 386-390.
    CrossrefPubMedGoogle Scholar
  • 12 Harris ED. Clinical features of rheumatoid arthritis. In: Ruddy S, Harris ED, Sledge CB. (eds). Kelley’s textbook of rheumatology. Philadelphia: WB. Saunders Company; 2001: 967-1000.
    Google Scholar
  • 13 Hulsmans HM, Jacobs JW, van der Heijde DM. et al. The course of radiologic damage during the first six years of rheumatoid arthritis. Arthritis Rheum 2000; 43: 1927-1940.
    CrossrefPubMedGoogle Scholar
  • 14 Kaim AH, Weber B, Kurrer MO. et al. Autoradiographic quantification of 18F-FDG uptake in experimental soft-tissue abscesses in rats. Radiology 2002; 223: 446-451.
    CrossrefPubMedGoogle Scholar
  • 15 Kubota K, Ito K, Morooka M. et al. Whole-body FDG-PET/CT on rheumatoid arthritis of large joints. Ann Nucl Med 2009; 23: 783-791.
    CrossrefPubMedGoogle Scholar
  • 16 Kubota K, Ito K, Morooka M. et al. FDG PET for rheumatoid arthritis: basic considerations and whole-body PET/CT. Ann NY Acad Sci 2011; 1228: 29-38.
    CrossrefPubMedGoogle Scholar
  • 17 Kücükdeveci AA, Sahin H, Ataman S. et al. Issues in crosscultural validity: example from the adaptation, reliability, and validity testing of a Turkish version of the Stanford Health Assessment Questionnaire. Arthritis Rheum 2004; 51: 14-19.
    CrossrefPubMedGoogle Scholar
  • 18 Minaker K, Little H. Painful feet in rheumatoid arthritis. Can Med Assoc J 1973; 20 109: 724-725.
    PubMedGoogle Scholar
  • 19 Moon YL, Lee SH, Park SY. et al. Evaluation of shoulder disorders by 2-[18F]-fluoro-2-deoxy-D-glucose positron emission tomography and computed tomography. Clin Orthop Surg 2010; 2: 167-172.
    CrossrefPubMedGoogle Scholar
  • 20 O’Dell JR. Rheumatoid arthritis: the clinical picture. In: Koopman WJ. (ed). Arthritis and allied conditions. Philadelphia: Lippincott Williams and Wilkins; 2001: 1153-1186.
    Google Scholar
  • 21 Ostendorf B, Scherer A, Mödder U. et al. Diagnostic value of magnetic resonance imaging of the forefeet in early rheumatoid arthritis when findings on imaging of the metacarpophalangeal joints of the hands remain normal. Arthritis Rheum 2004; 50: 2094-2102.
    CrossrefPubMedGoogle Scholar
  • 22 Ostergaard M, Stoltenberg M, Løvgreen-Nielsen P. et al. Quantification of synovistis by MRI: correlation between dynamic and static gadolinium-enhanced magnetic resonance imaging and microscopic and macroscopic signs of synovial inflammation. Magn Reson Imaging 1998; 16: 743-754.
    CrossrefPubMedGoogle Scholar
  • 23 Palmer WE, Rosenthal DI, Schoenberg OI. et al. Quantification of inflammation in the wrist with gadolinium-enhanced MR imaging and PET with 2-[F-18]-fluoro-2-deoxy-D-glucose. Radiology 1995; 196: 647-655.
    CrossrefPubMedGoogle Scholar
  • 24 Polisson RP, Schoenberg OI, Fischman A. et al. Use of magnetic resonance imaging and positron emission tomography in the assessment of synovial volume and glucose metabolism in patients with rheumatoid arthritis. Arthritis Rheum 1995; 38: 819-825.
    CrossrefPubMedGoogle Scholar
  • 25 Prevoo ML, van’t Hof MA, Kuper HH. et al. Modified disease activity scores that include twentyeight- joint counts. Development and validation in a prospective longitudinal study of patients with rheumatoid arthritis. Arthritis Rheum 1995; 38: 44-48.
    CrossrefPubMedGoogle Scholar
  • 26 Seldin DW, Habib I, Soudry G. Axillary lymph node visualization on F-18 FDG PET body scans in patients with rheumatoid arthritis. Clin Nucl Med 2007; 32: 524-526.
    CrossrefPubMedGoogle Scholar
  • 27 Serdaroglu M, Cakirbay H, Deger O. et al. The association of anti-CCP antibodies with disease activity in rheumatoid arthritis. Rheumatol Int 2008; 28: 965-970.
    CrossrefPubMedGoogle Scholar
  • 28 Steinbrocker O, Traeger CH, Batterman RC. Therapeutic criteria for rheumatoid arthritis. JAMA 1949; 140: 659-666.
    CrossrefPubMedGoogle Scholar
  • 29 Tateishi U, Imagawa T, Kanezawa N. et al. PET assessment of disease activity in children with juvenile idiopathic arthritis. Pediatr Radiol 2010; 40: 1781-1788.
    CrossrefPubMedGoogle Scholar
  • 30 Turner DE, Helliwell PS, Emery P. et al. The impact of rheumatoid arthritis on foot function in the early stages of disease: a clinical case series. BMC Musculoskelet Disord 2006; 7: 102.
    CrossrefPubMedGoogle Scholar
  • 31 Van Riel PL, Fransen J. Established rheumatoid arthritis: clinical assessments. Best Pract Res Clin Rheumatol 2007; 21: 807-825.
    CrossrefPubMedGoogle Scholar