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PET/CT imaging in polymyalgia rheumatica: praepubic 18F-FDG uptake correlates with pectineus and adductor longus muscles enthesitis and with tenosynovitis

Zdenek Rehak
Zdenek Rehak
, 
Andrea Sprlakova-Pukova
Andrea Sprlakova-Pukova
, 
Zbynek Bortlicek
Zbynek Bortlicek
, 
Zdenek Fojtik
Zdenek Fojtik
, 
Tomas Kazda
Tomas Kazda
, 
Marek Joukal
Marek Joukal
, 
Renata Koukalova
Renata Koukalova
, 
Jiri Vasina
Jiri Vasina
, 
Jana Eremiasova
Jana Eremiasova
 und 
Petr Nemec
Petr Nemec
   | 14. Jan. 2017
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Article Category: Research Article
Online veröffentlicht: 14. Jan. 2017
Seitenbereich: 8 - 14
Eingereicht: 29. Aug. 2016
Akzeptiert: 14. Dez. 2016
DOI: https://doi.org/10.1515/raon-2017-0001
© 2017 Zdenek Rehak, Andrea Sprlakova-Pukova, Zbynek Bortlicek, Zdenek Fojtik, Tomas Kazda, Marek Joukal, Renata Koukalova, Jiri Vasina, Jana Eremiasova, Petr Nemec
This article is distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Initial 18FDG-PET/CT examination of all 15 examined patients, showing transversal planes through maximal praepubic uptake. Visually detectable accumulation can be observed in all patients.
Initial 18FDG-PET/CT examination of all 15 examined patients, showing transversal planes through maximal praepubic uptake. Visually detectable accumulation can be observed in all patients.

Control 18FDG-PET/CT examination showing corresponding transversal slices as in Figure 1. Compared with Figure 1, decrease or complete diminishment of 18FDG accumulation is observable in all patients.
Control 18FDG-PET/CT examination showing corresponding transversal slices as in Figure 1. Compared with Figure 1, decrease or complete diminishment of 18FDG accumulation is observable in all patients.

Patients’ baseline characteristics

CharacteristicsNumbers (%)n= 15 (100%)
Sex, n (%)
 females10 (66.7 %)
 males5 (33.3 %)
Age at the disease onset
 median (min-max)70 years (53-78)
Time to follow up exam
 median (min-max)8 months (3-49)

Nuclear medicine data at baseline and follow up examination

Baselinemedian (min-max)Follow upmedian (min-max)p-valuemedian (min-max)
18F-FDG366 MBq (327-434)362 MBq (301-400)0.271
Praepubic / liver 18F-FDG uptake1.50 (1.12-2.15)0.58 (0.35-0.99)0.001

Changes in analysed laboratory parameters between baseline and follow up examination

Baselinemedian (min-max)Follow upmedian (min-max)p-valuemedian (min-max)
CRP57 mg/l (17-137)3 mg/l (1-17)0.001
FW74 mm/hod (44-120)16 mm/hod (5-40)0.001

Imaging and laboratory results of all patients. Reported baseline treatment was initiated several days after baseline PET/CT

NoDiseasestatusDate of baseline(B) andfollow up (FU)examinationTime tocontrolexam(months)B/FUpraepubicto liveruptake ratioB/FU FW(mm/h)B/FU CRP(mg/dL)B/FUtreatment(mg/day)B/ FU region of positivity ofother PMR areas (target-to-liver ratio)B/FUvascularpositivity
1R11-18-20144.01.1344423P 15S 2.23, H 1.25, Scl 1.13, Isch1.45no positivity
3-20-20150.576161.4P 5H 1.11no positivity
2N2-23-201048.71.23412049P 15S 1.65, H 1.24, Scl 1.24, Isch1.17, L 1.14no positivity
3-15-20140.8122616.9M 8no positivityno positivity
3N9-1-20143.22.148120137P 60S 1.87, Scl 1.45, H 2.31, Isch1.65, L 1.12, Th 1.14, C 1.24no positivity
12-8-20140.9923516.7P 10S 1.36no positivity
4N7-24-20106.11.89112056.8P 40S 1.78, Scl 1.54, H 1, Isch 2.21,L 1.08no positivity
1-25-20110.345305.7P 2.5no positivityno positivity
5N3-13-201412.01.7726028.5P 20S 2.02, H 1.47, Scl 1.24, Isch2.02, L 1.23V3/6
3-13-20150.98771P 0no positivityV1/6no positivity
6N10-14-201316.91.2985445P 20S1.78, H1.88, Scl 1.95, L 1.25,Isch 1.16
3-13-20150.53765.3P 2.5no positivityno positivity
7R1-3-201413.11.3027778.3M 16S 1.78, H 1.87, Scl 1.35, Isch1.65, L 1.12V4/6
2-6-20150.40351.9M 2no positivityno positivity
8N6-9-201233.11.8355076P 30S 2.21, H 2.16, Scl 1.8, Isch1.78, L 1.2V4/6
3-13-20150.54143.1P 0H 1.23V2/6
9N6-3-20153.11.5026041.5P 15S 2.36, H 2.24, Scl 2.03, Isch2.04, C 1.11no positivity
9-4-20150.761613.4P 10no positivityno positivityno positivity
10N1-8-201421.71.2098078.3P 60S 1.84, H1.78, Scl 1.69, Isch1.57, L 1.23
10-30-20150.395102.5P 7.5no positivityno positivity
11R3-4-20158.11.5466216.5M 48 +MTX 10/weekM 4 +S 2.66, H 2.74, Scl 2.0, Isch1.72, C 1.47, L 1.48V5/6
11-5-20150.811303.3MTX 10/weekH 1.14, C 1.08, S 1.11, Scl 1.07S 2.27, H 2.06, Scl 2.16, IschV3/6
12N2-6-20158.31.78912098.7M 323.03, L 1.45no positivity
10-16-20150.97407.5M 8Scl 1.14, Isch 1.21no positivity
13N1-23-2015141.1237067.5P 15S 1.78, H 1.87, Scl 1.69, Isch1.57, L 1.24no positivity
3-24-20160.44161.4P 5no positivityno positivityno positivity
14N9-16-20155.81.2827452P 20S 2.44, H 3.04, Scl 2.07, L 1.21
3-9-20160.41243.2P 7.5no positivityno positivity
15N10-26-20153.21.89280118.8P 30S 2.93, H 2.97, Isch 3.22, C1.44, L 1.24, Th 1.17, Scl 1.79V4/6
2-1-20160.67851.3P20no positivityno positivity
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