TY - JOUR
T1 - Whole-Body Macrophage Positron Emission Tomography Imaging for Disease Activity Assessment in Early Rheumatoid Arthritis
AU - Verweij, Nicki J. F.
AU - de Jongh, Jerney
AU - Wee, Marieke M. Ter
AU - Zwezerijnen, Gerben J. C.
AU - Yaqub, Maqsood
AU - Voskuyl, Alexandre E.
AU - Lammertsma, Adriaan A.
AU - van Schaardenburg, Dirkjan
AU - Boers, Maarten
AU - Lems, Willem F.
AU - van der Laken, Conny J.
N1 - Funding Information: This work was supported by Pfizer, AbbVie, ReumaNederland (14-1-302), and ZonMw (436001001). 1N.J.F. Verweij, MD, J. de Jongh, MSc, A.E. Voskuyl, MD, Professor, W.F. Lems, MD, Professor, C.J. van der Laken, MD, PhD, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Amsterdam UMC, Vrije Universiteit; 2M.M. ter Wee, PhD, M. Boers, MD, Professor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, and Department of Epidemiology and Data Science, Amsterdam Public Health, Amsterdam UMC, Vrije Universiteit; 3G.J.C. Zwezerijnen, MD, M. Yaqub, PhD, A.A. Lammertsma, PhD, Professor, Department of Radiology & Nuclear Medicine, Amsterdam UMC, Vrije Universiteit; 4D. van Schaardenburg, MD, Professor, Department of Rheumatology, Amsterdam Rheumatology and Immunology Center, Reade, Amsterdam, the Netherlands. The authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. J. van der Laken, Department of Rheumatology, Amsterdam UMC - location VUmc, P.O. Box 7057, 1007 MB Amsterdam, the Netherlands. Email: j.vanderlaken@amsterdamumc.nl. Accepted for publication April 5, 2022. Publisher Copyright: © 2022 The Journal of Rheumatology.
PY - 2022/8/1
Y1 - 2022/8/1
N2 - Objective. To investigate the potential of whole-body positron emission tomography/computed tomography (PET/CT) with a macrophage tracer to image arthritis in patients with early rheumatoid arthritis (RA). Methods. Thirty-five previously untreated, clinically active patients with early RA underwent whole-body PET/CT scanning with the macrophage tracer (R)-[11C]PK11195 in addition to clinical assessment (Disease Activity Score in 44 joints [DAS44]). Tracer uptake was assessed quantitatively as standardized uptake values (SUVs). In addition, 2 readers blinded to clinical assessment visually scored tracer uptake in joints. Clinical and PET variables were compared using Cohen κ, linear regression/correlation, and t tests, where appropriate. Results. All but 1 patient showed enhanced tracer uptake in at least 1 joint. Twelve percent of all joints (171/1470) were visually positive on the PET scan, most frequently the small joints in feet (40%) and hands (37%), followed by wrists (15%). Correlations of visual scores with clinical findings both at patient and joint levels were absent or weak. In contrast, average SUVs in the hands, feet, and whole body showed significant correlations with DAS44 scores, with the best correlation seen in the feet (R2 = 0.29, P < 0.01). Conclusion. Clinically active patients with early RA had increased joint uptake of a macrophage PET tracer, especially in the feet. Quantitative, but not visual PET measures of whole body and joint groups, particularly the feet, showed moderate and statistically significant correlations with clinical outcome.
AB - Objective. To investigate the potential of whole-body positron emission tomography/computed tomography (PET/CT) with a macrophage tracer to image arthritis in patients with early rheumatoid arthritis (RA). Methods. Thirty-five previously untreated, clinically active patients with early RA underwent whole-body PET/CT scanning with the macrophage tracer (R)-[11C]PK11195 in addition to clinical assessment (Disease Activity Score in 44 joints [DAS44]). Tracer uptake was assessed quantitatively as standardized uptake values (SUVs). In addition, 2 readers blinded to clinical assessment visually scored tracer uptake in joints. Clinical and PET variables were compared using Cohen κ, linear regression/correlation, and t tests, where appropriate. Results. All but 1 patient showed enhanced tracer uptake in at least 1 joint. Twelve percent of all joints (171/1470) were visually positive on the PET scan, most frequently the small joints in feet (40%) and hands (37%), followed by wrists (15%). Correlations of visual scores with clinical findings both at patient and joint levels were absent or weak. In contrast, average SUVs in the hands, feet, and whole body showed significant correlations with DAS44 scores, with the best correlation seen in the feet (R2 = 0.29, P < 0.01). Conclusion. Clinically active patients with early RA had increased joint uptake of a macrophage PET tracer, especially in the feet. Quantitative, but not visual PET measures of whole body and joint groups, particularly the feet, showed moderate and statistically significant correlations with clinical outcome.
KW - diagnostic imaging
KW - radionuclide imaging
KW - rheumatoid arthritis
UR - http://www.scopus.com/inward/record.url?scp=85135369809&partnerID=8YFLogxK
U2 - https://doi.org/10.3899/jrheum.210928
DO - https://doi.org/10.3899/jrheum.210928
M3 - Article
C2 - 35428723
SN - 0315-162X
VL - 49
SP - 871
EP - 877
JO - Journal of rheumatology
JF - Journal of rheumatology
IS - 8
ER -