RT Journal Article
SR Electronic
T1 Vessel inflammation and morphological changes in patients with large vessel vasculitis: a retrospective study
JF RMD Open
JO RMD Open
FD EULAR
SP e001977
DO 10.1136/rmdopen-2021-001977
VO 8
IS 1
A1 Besutti, Giulia
A1 Muratore, Francesco
A1 Mancuso, Pamela
A1 Ferrari, Marco
A1 Galli, Elena
A1 Spaggiari, Lucia
A1 Monelli, Filippo
A1 Casali, Massimiliano
A1 Versari, Annibale
A1 Boiardi, Luigi
A1 Marvisi, Chiara
A1 Ligabue, Guido
A1 Pattacini, Pierpaolo
A1 Giorgi Rossi, Paolo
A1 Salvarani, Carlo
YR 2022
UL http://rmdopen.bmj.com/content/8/1/e001977.abstract
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.