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Shigeru Tanaka, Kei Ikeda, Katsuhiro Uchiyama, Taro Iwamoto, Yoshie Sanayama, Ayako Okubo, Daiki Nakagomi, Kentaro Takahashi, Masaya Yokota, Akira Suto, Kotaro Suzuki, Hiroshi Nakajima, [18F]FDG uptake in proximal muscles assessed by PET/CT reflects both global and local muscular inflammation and provides useful information in the management of patients with polymyositis/dermatomyositis, Rheumatology, Volume 52, Issue 7, July 2013, Pages 1271–1278, https://doi.org/10.1093/rheumatology/ket112
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Abstract
Objective. This study aimed to determine whether [18F]fluorodeoxyglucose-PET/CT ([18F]FDG-PET/CT) discriminates PM/DM from non-muscular diseases and also whether FDG uptake in proximal muscles reflects the activity and severity of muscular inflammation in PM/DM.
Methods. Twenty treatment-naïve PM/DM patients who underwent [18F]FDG-PET/CT were retrospectively identified by reviewing medical records. The same number of age- and sex-matched control patients with non-muscular diseases were also identified. Standardized uptake value (SUV) was calculated for each of the seven proximal muscles. For patient-based assessment, mean proximal muscle SUV was calculated by averaging the SUVs for these proximal muscles bilaterally.
Results. Mean proximal muscle SUVs were significantly greater in PM/DM patients than in control patients (median 1.05 vs 0.69, P < 0.001). Mean proximal muscle SUVs significantly correlated with mean proximal manual muscle test scores (ρ = 0.49, P = 0.028) and serum levels of creatine kinase (ρ = 0.54, P = 0.015) and aldolase (ρ = 0.64, P = 0.002). Furthermore, SUVs in proximal muscles from which biopsy specimens were obtained significantly correlated with histological grade for inflammatory cell infiltration (ρ = 0.66, P = 0.002).
Conclusion. Our results suggest that [18F]FDG-PET/CT is useful in the diagnosis of PM/DM when inflammation in proximal muscles is globally assessed with quantitative measurements. Our results also indicate that local FDG uptake in a proximal muscle reflects the activity of inflammation in the same muscle and provides useful information in determining the region for muscle biopsy.
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