PET/CT of cranial arteries for a sensitive diagnosis of giant cell arteritis - INRAE - Institut national de recherche pour l’agriculture, l’alimentation et l’environnement Access content directly
Journal Articles Rheumatology Year : 2022

PET/CT of cranial arteries for a sensitive diagnosis of giant cell arteritis

Laurent Martin
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Abstract

OBJECTIVES: To investigate the performance of cranial PET/CT for the diagnosis of giant cell arteritis (GCA). METHODS: All patients with a suspected diagnosis of GCA were prospectively enrolled in this study and had a digital PET/CT with evaluation of cranial arteries if they had not started glucocorticoids more than 72 hours previously. The diagnosis of GCA was retained after at least 6 months of follow-up if no other diagnosis was considered by the clinician and the patient went into remission after at least 6 consecutive months of treatment. Cranial PET/CT was considered positive if at least one arterial segment showed hypermetabolism similar to or greater than liver uptake. RESULTS: For cranial PET/CT, sensitivity (Se), specificity (Sp), positive predictive value (PPV) and negative predictive value (NPV) were 73.3%, 97.2%, 91.7% and 89.7%, respectively. For extracranial PET/CT, diagnostic performance was lower (Se = 66.7%, Sp = 80.6%, PPV = 58.8%, NPV = 85.3%). The combination of cranial and extracranial PET/CT improved overall sensitivity (Se = 80%) and NPV (NPV = 90.3%) while decreasing overall specificity (Sp = 77.8%) and PPV (PPV = 60%). CONCLUSION: Cranial PET/CT can be easily combined with extracranial PET/CT with a limited increase in examination time. Combined cranial and extracranial PET/CT showed very high diagnostic accuracy for the diagnosis of GCA. TRIAL REGISTRATION: ClinicalTrials.gov, https://clinicaltrials.gov, NCT05246540.
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hal-03745097 , version 1 (03-08-2022)

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Thomas Thibault, Bastien Durand-Bailloud, Agnès Soudry-Faure, Hélène Greigert, Clément Drouet, et al.. PET/CT of cranial arteries for a sensitive diagnosis of giant cell arteritis. Rheumatology, 2022, pp.keac430. ⟨10.1093/rheumatology/keac430⟩. ⟨hal-03745097⟩
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