High-resolution 18F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis

Findings of a prospective pilot study

Abhijit Chaudhari, Andrea Ferrero, Felipe Godinez, Kai Yang, David K. Shelton, John C Hunter, Stanley M Naguwa, John M Boone, Siba P Raychaudhuri, Ramsey D Badawi

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Abstract

Objective: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, highresolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. Methods: Patients with RA or PsA underwent fluorine-18 fludeoxyglucose (18F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform-triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. Results: Significantly elevated 18F-FDG uptake was measured for the radiocarpal and pisiform-triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p<0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated 18F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p<0.05), with patterns of 18F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. Conclusion: High-resolution 18F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). Advances in knowledge: High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for noninvasive, objective assessment of RA or PsA severity and therapy selection.

Original languageEnglish (US)
Article number20160138
JournalBritish Journal of Radiology
Volume89
Issue number1063
DOIs
StatePublished - 2016

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Psoriatic Arthritis
Fluorodeoxyglucose F18
Positron-Emission Tomography
Rheumatoid Arthritis
Synovitis
Prospective Studies
Nails
Joints
Hand Joints
Tenosynovitis
Wrist Joint
Wrist
Arthritis
Edema
Hand
Bone and Bones
Fluorine
Tendons
Extremities
Pathology

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

@article{7a0cb80cc26543e797faa9b8fc242e58,
title = "High-resolution 18F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis: Findings of a prospective pilot study",
abstract = "Objective: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, highresolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. Methods: Patients with RA or PsA underwent fluorine-18 fludeoxyglucose (18F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform-triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. Results: Significantly elevated 18F-FDG uptake was measured for the radiocarpal and pisiform-triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p<0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated 18F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p<0.05), with patterns of 18F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. Conclusion: High-resolution 18F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). Advances in knowledge: High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for noninvasive, objective assessment of RA or PsA severity and therapy selection.",
author = "Abhijit Chaudhari and Andrea Ferrero and Felipe Godinez and Kai Yang and Shelton, {David K.} and Hunter, {John C} and Naguwa, {Stanley M} and Boone, {John M} and Raychaudhuri, {Siba P} and Badawi, {Ramsey D}",
year = "2016",
doi = "10.1259/bjr.20160138",
language = "English (US)",
volume = "89",
journal = "British Journal of Radiology",
issn = "0007-1285",
publisher = "British Institute of Radiology",
number = "1063",

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TY - JOUR

T1 - High-resolution 18F-FDG PET/CT for assessing disease activity in rheumatoid and psoriatic arthritis

T2 - Findings of a prospective pilot study

AU - Chaudhari, Abhijit

AU - Ferrero, Andrea

AU - Godinez, Felipe

AU - Yang, Kai

AU - Shelton, David K.

AU - Hunter, John C

AU - Naguwa, Stanley M

AU - Boone, John M

AU - Raychaudhuri, Siba P

AU - Badawi, Ramsey D

PY - 2016

Y1 - 2016

N2 - Objective: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, highresolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. Methods: Patients with RA or PsA underwent fluorine-18 fludeoxyglucose (18F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform-triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. Results: Significantly elevated 18F-FDG uptake was measured for the radiocarpal and pisiform-triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p<0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated 18F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p<0.05), with patterns of 18F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. Conclusion: High-resolution 18F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). Advances in knowledge: High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for noninvasive, objective assessment of RA or PsA severity and therapy selection.

AB - Objective: Rheumatoid arthritis (RA) and psoriatic arthritis (PsA) commonly affect the small joints of the wrist and hand. We evaluated the performance of a new, highresolution extremity positron emission tomography (PET)/CT scanner for characterizing and quantifying pathologies associated with the two arthritides in the wrist and hand joints. Methods: Patients with RA or PsA underwent fluorine-18 fludeoxyglucose (18F-FDG) PET/CT wrist and hand imaging, respectively, on the high-resolution scanner. Calibrated CT images and co-registered PET images were reconstructed. PET/CT was derived for the radiocarpal and pisiform-triquetral compartments, joints with erosive changes, sites of synovitis or tenosynovitis and the nail bed and were correlated with clinical and MRI findings. Results: Significantly elevated 18F-FDG uptake was measured for the radiocarpal and pisiform-triquetral compartments and at sites of bone erosion, synovitis, pannus and oedema, compared with unaffected joints (p<0.05) in patients with RA, consistent with their clinical findings. In patients with PsA, significantly elevated 18F-FDG uptake was measured for joints with synovitis compared with unaffected joints (p<0.05), with patterns of 18F-FDG uptake along the tendons, at the enthesis and in the nail bed, consistent with tenosynovitis, enthesitis and nail dystrophy, respectively. Conclusion: High-resolution 18F-FDG PET/CT imaging of the wrist and hand is feasible in an RA or PsA patient cohort and is capable of providing quantifiable measures of disease activity (synovitis, enthesitis, oedema and bone destruction). Advances in knowledge: High-resolution PET/CT imaging shows promise as a tool for understanding the pathogenesis of the arthritic process and for noninvasive, objective assessment of RA or PsA severity and therapy selection.

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