Semi-Quantitative [18F]FDG-PET/CT ROC-Analysis-Based Cut-Offs for Aortitis Definition in Giant Cell Arteritis
Abstract
:1. Introduction
2. Results
2.1. Patients
2.2. [18F]FDG-PET/CT Semi-Quantitative Features
2.3. Diagnostic Semi-Quantitative Cut-Off Values from ROC Curves
3. Discussion
4. Materials and Methods
4.1. Standard Reference
4.2. [18F]FDG-PET/CT Acquisition and Analysis
- Target-to-liver ratio (TBRliver) by placing a ROI in the healthy right lobe of the liver;
- Target-to-blood pool ratio (TBRblood) defined for supra-diaphragmatic vessels by a ROI drawn centrally in the blood pool of the superior vena cava and for infra-diaphragmatic vessels in the blood pool of the inferior vena cava.
4.3. Statistical Analysis
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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GCA Aortitis n = 35 | Aortic Atheroma n = 70 | Control n = 35 | p Value1 | p Value2 | |
---|---|---|---|---|---|
Median age (Q1–Q3) | 67 (60.7–72.2) | 73 (63–77) | 70 (61.5–74) | 0.21 | 0.64 |
Female sexn (%) | 30 (85.7) | 61 (87.1) | 30 (85.7) | 0.84 | >0.99 |
FDG-PET/CT parameters | |||||
Mean18F-FDG dose (MBq/kg) | 3.0 (±0.06) | 3.0 (±0.05) | 3.0 (±0.04) | 0.09 | 0.17 |
Mean time between injection and imaging (min) (±SD) | 64.8 (±6.8) | 63.5 (±7.6) | 62.1 (±6.3) | 0.38 | 0.004 |
Biological settings | |||||
Mean blood glucose level before FDG-PET/CT imaging (mmol/L) (±SD) | 5.3 (±0.98) | 5.5 (±1.0) | 5.6 (±1.24) | 0.34 | 0.43 |
CRP > 10 mg/Ln (%) | 22 (62.9) | 8 (11.4) | 3 (8.6) | <0.001 | <0.001 |
CRP mg/L mean ± SD | 65.7 ± 55.2 | 8.8 ± 30.4 | 2.7 ± 9.8 | <0.001 | <0.001 |
Glucocorticoids before PETn (%) | 16 (45.7) | 9 (12.6) | 2 (5.7) | 0.001 | <0.001 |
Patients with hepatic cytolysisn (%) | 1 (2.9) | 14 (20.0) | 6 (17.1) | 0.02 | 0.04 |
GFR mL/min(±SD) | 81.5 (±16.6) | 80.2 (±20.0) | 85.8 (±17.8) | 0.70 | 0.30 |
GFR <60 mL/minn (%) | 4 (11.4) | 8 (11.4) | 3 (8.5) | >0.99 | 0.69 |
Mean; Median [IQR] | GCA Aortitis without GC n = 19 | GCA Aortitis Treated with GC n = 16 | Aortic Atheroma n = 70 | Control n = 35 | p |
---|---|---|---|---|---|
SUVmax liver | 3.3;3.2 [2.95, 3.40] | 3.4;3.4 [3.08, 3.52] | 3.3;3.2 [2.95, 3.60] | 3.6;3.4 [3.20, 3.90] | 0.047 |
SUVmax blood | 1.8;1.9 [1.50, 1.95] | 1.8;1.9 [1.58, 2.02] | 1.8;1.8 [1.60, 2.00] | 1.9;1.8 [1.60, 2.10] | 0.697 |
SUVmax aortic | 5.9;5.5 [4.25, 7.40] | 4.1;3.9 [3.38, 4.53] | 2.9;2.90 [2.65, 3.20] | 2.9;2.9 [2.70, 3.00] | <0.001 |
TBR liver | 1.8;1.6 [1.31, 2.35] | 1.2;1.1 [0.97, 1.45] | 0.8;0.8 [0.73, 0.88] | 0.9;0.9 [0.82, 0.97] | <0.001 |
TBR blood | 3.4;3.0 [2.33, 4.21] | 2.3;2.1 [1.84, 2.76] | 1.6;1.5 [1.39, 1.77] | 1.7;1.6 [1.49, 1.81] | <0.001 |
Aortic Visual Grading | SUVmax | TBRliver | TBRblood |
---|---|---|---|
Grade 0 | 2.6 ± 0.4 | 0.8 ± 0.1 | 1.4 ± 0.3 |
Grade 1 | 2.8 ± 0.5 | 0.9 ± 0.1 | 1.6 ± 0.3 |
Grade 2 | 3.6 ± 0.5 | 1.0 ± 0.2 | 1.9 ± 0.4 |
Grade 3 | 5.1 ± 1.7 | 1.6 ± 0.5 | 2.9 ± 1.2 |
Aortitis with GC vs. All Controls | Aortitis without GC vs. All Controls | |||||
---|---|---|---|---|---|---|
SUVmax | TBR Blood | TBR Liver | SUVmax | TBR Blood | TBR Liver | |
Overall aorta | ||||||
AUC [CI 95%] | 0.86 [0.74;0.98] | 0.83 [0.69;0.96] | 0.85 [0.73;0.96] | 0.89 [0.76;1] | 0.96 [0.93;1] | 0.91 [0.81;1] |
Cut-off | 3.25 | 1.75 | 0.97 | 3.45 | 1.97 | 1.09 |
Specificity | 0.83 | 0.75 | 0.82 | 0.90 | 0.93 | 0.96 |
Sensitivity | 0.81 | 0.81 | 0.75 | 0.89 | 0.89 | 0.83 |
Thoracic aorta | ||||||
AUC [CI 95%] | 0.89 [0.79;0.99] | 0.84 [0.73;0.96] | 0.89 [0.79;0.98] | 0.90 [0.78;1] | 0.96 [0.93;1] | 0.93 [0.84;1] |
Cut-off | 3.25 | 1.75 | 0.97 | 3.45 | 1.77 | 1.09 |
Specificity | 0.81 | 0.80 | 0.80 | 0.93 | 0.81 | 0.97 |
Sensitivity | 0.88 | 0.81 | 0.88 | 0.88 | 1 | 0.82 |
Abdominal aorta | ||||||
AUC [CI 95%] | 0.89 [0.79;0.98] | 0.93 [0.86;1] | 0.89 [0.80;0.98] | 0.90 [0.78;1] | 0.94 [0.86;1] | 0.94 [0.85;1] |
Cut-off | 3.05 | 1.5 | 0.91 | 3.95 | 1.81 | 1.13 |
Specificity | 0.76 | 0.71 | 0.73 | 0.99 | 0.96 | 1 |
Sensitivity | 0.91 | 1 | 0.91 | 0.75 | 0.88 | 0.88 |
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Espitia, O.; Schanus, J.; Agard, C.; Kraeber-Bodéré, F.; Guédon, A.F.; Bénichou, A.; Serfaty, J.-M.; Coudol, S.; Karakachoff, M.; Jamet, B. Semi-Quantitative [18F]FDG-PET/CT ROC-Analysis-Based Cut-Offs for Aortitis Definition in Giant Cell Arteritis. Int. J. Mol. Sci. 2022, 23, 15528. https://doi.org/10.3390/ijms232415528
Espitia O, Schanus J, Agard C, Kraeber-Bodéré F, Guédon AF, Bénichou A, Serfaty J-M, Coudol S, Karakachoff M, Jamet B. Semi-Quantitative [18F]FDG-PET/CT ROC-Analysis-Based Cut-Offs for Aortitis Definition in Giant Cell Arteritis. International Journal of Molecular Sciences. 2022; 23(24):15528. https://doi.org/10.3390/ijms232415528
Chicago/Turabian StyleEspitia, Olivier, Jérémy Schanus, Christian Agard, Françoise Kraeber-Bodéré, Alexis F. Guédon, Antoine Bénichou, Jean-Michel Serfaty, Sandrine Coudol, Matilde Karakachoff, and Bastien Jamet. 2022. "Semi-Quantitative [18F]FDG-PET/CT ROC-Analysis-Based Cut-Offs for Aortitis Definition in Giant Cell Arteritis" International Journal of Molecular Sciences 23, no. 24: 15528. https://doi.org/10.3390/ijms232415528