18F-FDG-PET/CT Plays a Key Role in Formulating Treatment Strategies for Takayasu Arteritis

Backgroud and Objective: Clinical evaluation alone cannot satisfy the prognosis of TAK. PET-CTmolecular imaging may be a useful tool to supplement the prognosis of TAK. The purpose of this study was to observe whether THE TAK patients who achieved clinical remission also achieved imaging remission with PET-CT. Pet-ct plays an important role in the prognosis of TAK patients and further formulation of treatment strategy. Results: : 79% patients with TAK in remission were positive for 18 F-FDG-PET /CT. The study population had a mean age of 38.8 years and was predominantly female (90%). Their mean disease duration was 3.5 years and they had a mean disease remission period of 9.4 months. Patients had a mean ESR of 37.3 mm/h and a mean CRP level of 13.5 mg/l at the first dignosis time and 4.9 mm/h/3.7 mg/l at the Courrent time point. There was a statistically significant difference between the two groups (p<0.01). All patients on initial treatment received oral glucocorticoids, 25% received methotrexate, 65% received leflumide, and 45% received cyclophosphamide. Quantitative analysis of the SUV of nineteen patients showed an increasing trend (Baseline SUVmax 2.16±0.46 vs Remission SUVmax 2.08±0.49, p=0.56; Baseline SUVmean 2.34±0.57 vs Remission SUVmean 2.42±0.81, p=0.46). The arterial SUVmax uptake was higher in 15 patients with remission than baseline (2.30 ± 0.62 vs 2.48 ± 0.91, p = 0.54). But it was not statistically significant. Most of the patients (13/19, 68%) had an SUVmax value ≥ 2.0 in visual vasculitis with positive PET/CT before treatment, and 32% ＜2.0. No correlation was found between the type of treatment used, the time that elapsed from remission, or laboratory parameters and the scintigraphic results. Conclusion: TAK's clinical remission criteria are not entirely consistent with actual vascular inflammatory activity. Patients with TAK that achieve clinical remission may not achieve imaging remission with PET-CT, and PET-CT plays an important role in the prognosis of TAK patients and further formulation of treatment strategy.