18F-FDG-PET/MR imaging to monitor disease activity in large vessel vasculitis

Dan Pugh, Dilip Patel, Gillian Macnaught, Alicja Czopek, Lorraine Bruce, James Donachie, Peter J. Gallacher, Sovira Tan, Mark Ahlman, Peter C. Grayson, Neil Basu and Neeraj Dhaun ()
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Dan Pugh: University of Edinburgh
Dilip Patel: Royal Infirmary of Edinburgh
Gillian Macnaught: University of Edinburgh
Alicja Czopek: University of Edinburgh
Lorraine Bruce: University of Edinburgh
James Donachie: University of Edinburgh
Peter J. Gallacher: University of Edinburgh
Sovira Tan: National Institutes of Health
Mark Ahlman: Medical College of Georgia
Peter C. Grayson: National Institutes of Health
Neil Basu: University of Glasgow
Neeraj Dhaun: University of Edinburgh

Nature Communications, 2024, vol. 15, issue 1, 1-14

Abstract: Abstract Disease-monitoring in large vessel vasculitis (LVV) is challenging. Simultaneous 18F-fluorodeoxyglucose positron emission tomography with magnetic resonance imaging (PET/MRI) provides functional assessment of vascular inflammation alongside high-definition structural imaging with a relatively low burden of radiation exposure. Here, we investigate the ability of PET/MRI to monitor LVV disease activity longitudinally in a prospective cohort of patients with active LVV. We demonstrate that both the PET and MRI components of the scan can distinguish active from inactive disease using established quantification methods. Using logistic-regression modelling of PET/MRI metrics, we devise a novel PET/MRI-specific Vasculitis Activity using MR PET (VAMP) score which is able to distinguish active from inactive disease with more accuracy than established methods and detects changes in disease activity longitudinally. These findings are evaluated in an independent validation cohort. Finally, PET/MRI improves clinicians’ assessment of LVV disease activity and confidence in disease management, as assessed via clinician survey. In summary, PET/MRI may be useful in tracking disease activity and assessing treatment-response in LVV. Based on our findings, larger, prospective studies assessing PET/MRI in LVV are now warranted.

Date: 2024
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DOI: 10.1038/s41467-024-51613-1

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