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Rheumatology Advance Access originally published online on May 31, 2008
Rheumatology 2008 47(8):1179-1184; doi:10.1093/rheumatology/ken119
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Relationship between fluorodeoxyglucose uptake in the large vessels and late aortic diameter in giant cell arteritis

D. Blockmans1, W. Coudyzer2, S. Vanderschueren1, S. Stroobants3, D. Loeckx4, S. Heye2, L. De Ceuninck3, G. Marchal2 and H. Bobbaers1

1Department of General Internal Medicine, 2Department of Radiology, 3Department of Nuclear Medicine, Gasthuisberg University Hospital and 4Group of Medical Image Computing, Department of Electrical Engineering, Katholieke Universiteit Leuven, Leuven, Belgium.

Correspondence to: D. Blockmans, Department of Internal Medicine, Gasthuisberg University Hospital, Herestraat 49, 3000 Leuven, Belgium. E-mail: daniel.blockmans{at}uz.kuleuven.ac.be


  Abstract

Objective. GCA carries an increased risk of developing thoracic aortic aneurysms. Previous work with fluorodeoxyglucose (FDG)-PET has shown that the aorta is frequently involved in this type of vasculitis. We wanted to investigate whether there is a correlation between the extent of vascular FDG uptake during the acute phase of GCA and the aortic diameter at late follow-up.

Methods. All patients with biopsy-proven GCA who ever underwent an FDG-PET scan in our centre were asked to undergo a CT scan of the aorta. The diameter of the aorta was measured at six different levels (ascending aorta, aortic arch, descending aorta, abdominal suprarenal, juxtarenal and infrarenal aorta) and the volumes of the thoracic and of the abdominal aorta were calculated.

Results. Forty-six patients agreed to participate (32 females, 14 males). A mean of 46.7 ± 29.9 months elapsed between diagnosis and CT scan. All aortic dimensions were significantly smaller in women than in men, except for the diameter of the ascending aorta. Patients who had an increased FDG uptake in the aorta at diagnosis of GCA, had a significantly larger diameter of the ascending aorta (P = 0.025) and descending aorta (P = 0.044) and a significantly larger volume of the thoracic aorta (P = 0.029). In multivariate analysis, FDG uptake at the thoracic aorta was associated with late volume of the thoracic aorta (P = 0.039).

Conclusion. GCA-patients with increased FDG uptake in the aorta may be more prone to develop thoracic aortic dilatation than GCA patients without this sign of aortic involvement.

KEY WORDS: Giant cell arteritis, Temporal arteritis, Vasculitis, Large-vessel vasculitis, Aorta, Positron Emission tomography, Fluorodeoxyglucose, Aortic dilatation, Vascular inflammation, Aortic aneurysm

Submitted 13 December 2007; revised version accepted 20 February 2008.
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