Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study
Objective Giant cell arteritis (GCA) is characterized by cranial ischemia at diagnosis and late aortic structural disease. Repeated combined cranial and large‐vessel fluoro‐2‐deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scans were performed to assess the distributio...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2025-03-01
|
| Series: | ACR Open Rheumatology |
| Online Access: | https://doi.org/10.1002/acr2.70006 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1850259005411164160 |
|---|---|
| author | Anthony M. Sammel Ivan Ho Shon Daniel A. Moses Stacey Fredericks Gita Mathur Claudia M. Hillenbrand Edward Hsiao Geoffrey Schembri Rodger Laurent Eva A. Wegner |
| author_facet | Anthony M. Sammel Ivan Ho Shon Daniel A. Moses Stacey Fredericks Gita Mathur Claudia M. Hillenbrand Edward Hsiao Geoffrey Schembri Rodger Laurent Eva A. Wegner |
| author_sort | Anthony M. Sammel |
| collection | DOAJ |
| description | Objective Giant cell arteritis (GCA) is characterized by cranial ischemia at diagnosis and late aortic structural disease. Repeated combined cranial and large‐vessel fluoro‐2‐deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scans were performed to assess the distribution of vasculitis activity over time and the relationship with clinical outcomes. Methods Patients were eligible if they were enrolled in a 64‐patient inception suspected GCA cohort in 2016 to 2017 and had a positive temporal artery biopsy and/or PET/CT scan at diagnosis. At five years, patients underwent a PET/CT scan, magnetic resonance aortogram, and clinical assessment. Scans were reported for overall metabolic disease activity and a visual FDG avidity grade at each vascular territory. Results Sixteen patients met inclusion criteria, and 11 attended the five‐year visit. Median age was 75 years, 73% were women, and all were in remission. At five years, 4 (36%) patients had aortic dilatation (range 40–43 mm), and five (45%) had globally active scans. Cranial artery activity resolved in all patients between diagnosis and five years, but aortitis developed in four patients who previously had PET‐inactive aortas. Disease‐modifying rheumatic drug (DMARD) use at five years was associated with scan inactivity (P = 0.02). There was a trend toward a higher mean aortic diameter in those with aortitis at five years (40.2 mm vs 36.0 mm, P = 0.06) but not those with aortitis at diagnosis. Conclusion Vasculitis activity changed from cranial and large vessel to exclusively large vessel by five years. This may explain the preponderance of early cranial and late aortic complications in GCA. The potential role of long‐term DMARDs to mitigate smoldering vasculitis warrants further study. |
| format | Article |
| id | doaj-art-9aa174a26f1f424a9a8bde9ea4ba9fdc |
| institution | OA Journals |
| issn | 2578-5745 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | ACR Open Rheumatology |
| spelling | doaj-art-9aa174a26f1f424a9a8bde9ea4ba9fdc2025-08-20T01:55:58ZengWileyACR Open Rheumatology2578-57452025-03-0173n/an/a10.1002/acr2.70006Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational StudyAnthony M. Sammel0Ivan Ho Shon1Daniel A. Moses2Stacey Fredericks3Gita Mathur4Claudia M. Hillenbrand5Edward Hsiao6Geoffrey Schembri7Rodger Laurent8Eva A. Wegner9Prince of Wales Hospital, Randwick, New South Wales, Australia, and University of New South Wales Sydney New South Wales AustraliaPrince of Wales Hospital, Randwick, New South Wales, Australia, and University of New South Wales Sydney New South Wales AustraliaPrince of Wales Hospital, Randwick, New South Wales, Australia, and University of New South Wales Sydney New South Wales AustraliaPrince of Wales Hospital Randwick New South Wales AustraliaPrince of Wales Hospital, Randwick, New South Wales, Australia, and University of New South Wales Sydney New South Wales AustraliaUniversity of New South Wales Sydney New South Wales AustraliaRoyal North Shore Hospital St Leonards New South Wales AustraliaRoyal North Shore Hospital St Leonards New South Wales AustraliaRoyal North Shore Hospital St Leonards New South Wales AustraliaPrince of Wales Hospital, Randwick, New South Wales, Australia, and University of New South Wales Sydney New South Wales AustraliaObjective Giant cell arteritis (GCA) is characterized by cranial ischemia at diagnosis and late aortic structural disease. Repeated combined cranial and large‐vessel fluoro‐2‐deoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) scans were performed to assess the distribution of vasculitis activity over time and the relationship with clinical outcomes. Methods Patients were eligible if they were enrolled in a 64‐patient inception suspected GCA cohort in 2016 to 2017 and had a positive temporal artery biopsy and/or PET/CT scan at diagnosis. At five years, patients underwent a PET/CT scan, magnetic resonance aortogram, and clinical assessment. Scans were reported for overall metabolic disease activity and a visual FDG avidity grade at each vascular territory. Results Sixteen patients met inclusion criteria, and 11 attended the five‐year visit. Median age was 75 years, 73% were women, and all were in remission. At five years, 4 (36%) patients had aortic dilatation (range 40–43 mm), and five (45%) had globally active scans. Cranial artery activity resolved in all patients between diagnosis and five years, but aortitis developed in four patients who previously had PET‐inactive aortas. Disease‐modifying rheumatic drug (DMARD) use at five years was associated with scan inactivity (P = 0.02). There was a trend toward a higher mean aortic diameter in those with aortitis at five years (40.2 mm vs 36.0 mm, P = 0.06) but not those with aortitis at diagnosis. Conclusion Vasculitis activity changed from cranial and large vessel to exclusively large vessel by five years. This may explain the preponderance of early cranial and late aortic complications in GCA. The potential role of long‐term DMARDs to mitigate smoldering vasculitis warrants further study.https://doi.org/10.1002/acr2.70006 |
| spellingShingle | Anthony M. Sammel Ivan Ho Shon Daniel A. Moses Stacey Fredericks Gita Mathur Claudia M. Hillenbrand Edward Hsiao Geoffrey Schembri Rodger Laurent Eva A. Wegner Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study ACR Open Rheumatology |
| title | Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study |
| title_full | Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study |
| title_fullStr | Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study |
| title_full_unstemmed | Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study |
| title_short | Repeated Cranial and Large‐Vessel Positron Emission Tomography/Computed Tomography Scans and the Association With Structural Aortic Disease in Giant Cell Arteritis: A Five‐Year Observational Study |
| title_sort | repeated cranial and large vessel positron emission tomography computed tomography scans and the association with structural aortic disease in giant cell arteritis a five year observational study |
| url | https://doi.org/10.1002/acr2.70006 |
| work_keys_str_mv | AT anthonymsammel repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT ivanhoshon repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT danielamoses repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT staceyfredericks repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT gitamathur repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT claudiamhillenbrand repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT edwardhsiao repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT geoffreyschembri repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT rodgerlaurent repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy AT evaawegner repeatedcranialandlargevesselpositronemissiontomographycomputedtomographyscansandtheassociationwithstructuralaorticdiseaseingiantcellarteritisafiveyearobservationalstudy |