Positron emission tomography in giant cell arteritis and polymyalgia rheumatica : evidence for inflammation of the aortic arch
Faculty of Medicine and Health Sciences
New York, N.Y.
The American journal of medicine. - New York, N.Y.
, p. 246-249
Polymyalgia rheumatica, a clinical syndrome of proximal muscle pain and stiffness in older patients, is closely related to giant cell arteritis  and . Many patients with giant cell arteritis have polymyalgia-like complaints (2). Polymyalgia rheumatica is diagnosed by the exclusion of other disorders that can cause similar complaints and by its rapid response to low-dose corticosteroid treatment  and . The diagnosis of giant cell arteritis, on the other hand, requires a temporal artery biopsy; there are no noninvasive techniques to make that diagnosis. Positron emission tomography (PET) with a radiolabeled glucose analog, fluoro-18-deoxyglucose (18F-glucose), enables the in vivo measurements of glucose metabolism (5). 18F-glucose is transported across capillary and cell membranes in proportion to the rate of glucose uptake. PET with 18F-glucose is most often used in the assessment of cancer patients, because tumor cells have a greater glycolytic metabolism than normal tissue (6). However, increased glycolysis is also seen in activated leukocytes and macrophages  and . Because giant cell arteritis and polymyalgia rheumatica are characterized by laboratory signs of inflammation, we evaluated the use of PET with 18F-glucose in these conditions.