Role of 18F-fluorodeoxyglucose positron emission tomography/computed tomography for therapy evaluation of patients with large-vessel vasculitis

Systemic vasculitis is a multisystem disease characterized by inflammation of blood vessels. Diagnosing extension of the disease and evaluating the response to therapy are cornerstones in the clinical management of vasculitis, and imaging has a pivotal role in this field. We have evaluated nine patients with large-vessel vasculitis by F-18-fluorodeoxyglucose positron emission tomography/computed tomography (F-18-FDG-PET/CT) before and after treatment with corticosteroid. The evaluation of eight patients was negative at follow-up studies after therapy, and one was unchanged. F-18-FDG-PET/CT is a useful, accurate tool for establishing the diagnosis of large-vessel vasculitis and for evaluating disease extension in these patients. Despite the small number of patients enrolled, our study confirms this statement and offers preliminary evidence that it could also be a reliable, accurate tool for monitoring therapy in conjunction with clinical and biochemical findings.