TY  - JOUR
A1  - Koch, Vitali
A1  - Abt, Julia Anna Walburga
A1  - Grünewald, Leon David
A1  - Eichler, Katrin
A1  - D'Angelo, Tommaso
A1  - Martin, Simon S.
A1  - Albrecht, Moritz Hans Ernst
A1  - Thalhammer, Axel
A1  - Booz, Christian
A1  - Yel, Ibrahim
A1  - Bernatz, Simon
A1  - Mahmoudi, Scherwin
A1  - Harth, Marc
A1  - Derwich, Wojciech
A1  - Vogl, Thomas J.
A1  - Gray, Daphne
A1  - Gruber-Rouh, Tatjana
A1  - Jung, Georg
T1  - Systematic evaluation of imaging techniques and baseline characteristics in patients with suspected vasculitis
T2  - European journal of radiology open
N2  - Highlights
• MRI and ultrasound provided significant correlations between findings suggestive of vasculitis and the final diagnosis.
• Careful selection of available imaging techniques is warranted considering the time course, location, and clinical history.
• Considering its moderate diagnostic power to distinguish tracer uptake, a holistic view of PET/CT findings is essential.
Abstract
Purpose: To assess the diagnostic value of different imaging modalities in distinguishing systemic vasculitis from other internal and immunological diseases.
Methods: This retrospective study included 134 patients with suspected vasculitis who underwent ultrasound, magnetic resonance imaging (MRI), or 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) between 01/2010 and 01/2019, finally consisting of 70 individuals with vasculitis. The main study parameter was the confirmation of the diagnosis using one of the three different imaging modalities, with the adjudicated clinical and histopathological diagnosis as the gold standard. A secondary parameter was the morphological appearance of the vessel affected by vasculitis.
Results: Patients with systemic vasculitis had myriad clinical manifestations with joint pain as the most common symptom. We found significant correlations between different imaging findings suggestive of vasculitis and the final adjudicated clinical diagnosis. In this context, on MRI, vessel wall thickening, edema, and diameter differed significantly between vasculitis and non-vasculitis groups (p < 0.05). Ultrasound revealed different findings that may serve as red flags in identifying patients with vasculitis, such as vascular occlusion or halo sign (p = 0.02 vs. non-vasculitis group). Interestingly, comparing maximal standardized uptake values from PET/CT examinations with vessel wall thickening or vessel diameter did not result in significant differences (p > 0.05).
Conclusions: We observed significant correlations between different imaging findings suggestive of vasculitis on ultrasound or MRI and the final adjudicated diagnosis. While ultrasound and MRI were considered suitable imaging methods for detecting and discriminating typical vascular changes, 18F-FDG PET/CT requires careful timing and patient selection given its moderate diagnostic accuracy.
KW  - Vasculitis
KW  - Diagnostic imaging
KW  - Magnetic resonance imaging
KW  - Positron emission tomography
Y1  - 2022
UR  - http://publikationen.ub.uni-frankfurt.de/frontdoor/index/index/docId/78306
UR  - https://nbn-resolving.org/urn:nbn:de:hebis:30:3-783065
SN  - 2352-0477
VL  - 9
IS  - 100445
PB  - Elsevier
CY  - Amsterdam
ER  -