PT - JOURNAL ARTICLE AU - Besutti, Giulia AU - Muratore, Francesco AU - Mancuso, Pamela AU - Ferrari, Marco AU - Galli, Elena AU - Spaggiari, Lucia AU - Monelli, Filippo AU - Casali, Massimiliano AU - Versari, Annibale AU - Boiardi, Luigi AU - Marvisi, Chiara AU - Ligabue, Guido AU - Pattacini, Pierpaolo AU - Giorgi Rossi, Paolo AU - Salvarani, Carlo TI - Vessel inflammation and morphological changes in patients with large vessel vasculitis: a retrospective study AID - 10.1136/rmdopen-2021-001977 DP - 2022 Jan 01 TA - RMD Open PG - e001977 VI - 8 IP - 1 4099 - http://rmdopen.bmj.com/content/8/1/e001977.short 4100 - http://rmdopen.bmj.com/content/8/1/e001977.full SO - RMD Open2022 Jan 01; 8 AB - Objective The aim was to identify any association between imaging signs of vessel wall inflammation (positron emission tomography–CT (PET-CT) score and CT/MR wall thickening) and synchronous and subsequent vascular damage (stenoses/dilations) in patients with large vessel vasculitis (LVV).Methods Consecutive patients with LVV referred to a tertiary centre in 2007–2020 with baseline PET-CT and morphological imaging (CT/MR angiography) performed within 3 months were included. All available PET-CT and CT/MR scans were reviewed to assess PET-CT uptake (4-point semi-quantitative score), wall thickening, stenoses and dilations for 15 vascular segments. The associations of baseline PET score and CT/MR wall thickening with synchronous and incident stenoses/dilations at CT/MR performed 6–30 months from baseline were evaluated in per-segment and per-patient analyses. Respective areas under the receiver operating characteristic curve (AUC) were calculated.Results We included 100 patients with LVV (median age: 48 years, 22% males). Baseline PET score and wall thickening were strongly associated (Cuzick non-parametric test for trend across order groups (NPtrend) <0.001). The association with synchronous stenoses/dilations was weak for PET score (NPtrend=0.01) and strong for wall thickening (p<0.001). In per-patient analyses, sensitivity/specificity for ≥1 synchronous stenoses/dilations were 44%/67% for PET score ≥2 and 66.7%/60.5% for wall thickening. Subsequent CTs/MRs were available in 28 patients, with seven incident stenoses/dilations. Baseline PET score was strongly associated with incident stenoses/dilations (p=0.001), while baseline wall thickening was not (p=0.708), with AUCs for incident stenoses/dilations of 0.80 for PET score and 0.52 for wall thickening.Conclusion PET score and wall thickening are strongly associated, but only baseline PET score is a good predictor of incident vessel wall damage in LVV.Data are available upon reasonable request. Participant data that underlie the results reported in this manuscript will be shared after de-identification, beginning 6 months and ending at least 7 years after article publication, to researchers who provide a methodologically sound proposal with objectives consistent with those of the original study. Proposals and data access requests should be directed to the Area Vasta Emilia Nord Ethics Committee at CEReggioemilia@ausl.re.it as well as to the Authors at the Epidemiology Unit of AUSL–IRCCS di Reggio Emilia at info.epi@ausl.re.it, who are the data guardians. To gain access, data requestors will need to sign a data access agreement.