Development of a new simplified comprehensive scoring system for polymyalgia rheumatica: Integration of PET/CT findings and clinical features

IF 4.6 2区医学 Q1 RHEUMATOLOGY

Seminars in arthritis and rheumatism Pub Date : 2025-06-05 DOI:10.1016/j.semarthrit.2025.152767

Zhuoran Li, Kexin Chen, Yifeng Wu, Min Wu

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引用次数: 0

Abstract

Objective

This study, based on previous single-center data, aimed to integrate [18F] Fluorodeoxyglucose positron emission tomography/computed tomography (PET/CT) findings with the 2012 ACR/EULAR classification criteria for Polymyalgia rheumatica (PMR) to develop a new simplified comprehensive scoring system and further validate its diagnostic performance.

Methods

We conducted a retrospective review of patients aged ≥50 years with musculoskeletal pain who underwent PET/CT examinations over the past decade. A total of 125 patients with PMR and 200 control subjects were included. The cohort was divided into a study cohort and a validation cohort. Based on PET/CT findings and clinical characteristics from the study cohort, we developed a new simplified comprehensive scoring system. The diagnostic performance of this new scoring system was further assessed in the validation cohort.

Results

In the discovery cohort, the new scoring system, which combines PET/CT findings with clinical criteria, demonstrated a sensitivity of 92 % for diagnosing PMR, a specificity of 86.5 % in the overall control group, and a sensitivity of 90.4 % for distinguishing patients with rheumatoid arthritis (RA). The area under the receiver operating characteristic (ROC) curve (AUC) was 0.892 for the overall control group and 0.912 for the RA group. In the validation cohort, the new criteria achieved a sensitivity of 88 % and a specificity of 83.1 %.

Conclusions

The new simplified comprehensive scoring system integrates PET/CT findings with the 2012 ACR/EULAR clinical classification criteria, simplifying the scoring components to improve diagnostic performance and clinical utility, thus making it more accessible and practical for rheumatologists in clinical settings.

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开发一种新的简化综合评分系统用于风湿病多肌痛：整合PET/CT表现和临床特征

目的本研究在以往单中心数据的基础上，将[18F]氟氧葡萄糖正电子发射断层扫描/计算机断层扫描（PET/CT）结果与2012年ACR/EULAR风湿病多肌痛（PMR）分类标准相结合，建立新的简化综合评分系统，进一步验证其诊断效能。方法：我们对过去十年中接受PET/CT检查的年龄≥50岁的肌肉骨骼疼痛患者进行回顾性分析。共纳入125例PMR患者和200例对照组。该队列分为研究队列和验证队列。根据研究队列的PET/CT表现和临床特征，我们开发了一种新的简化综合评分系统。在验证队列中进一步评估了这种新的评分系统的诊断性能。结果在发现队列中，将PET/CT表现与临床标准相结合的新评分系统诊断PMR的敏感性为92%，总体对照组的特异性为86.5%，区分类风湿关节炎（RA）患者的敏感性为90.4%。总体对照组的受试者工作特征（ROC）曲线下面积（AUC）为0.892，RA组为0.912。在验证队列中，新标准的灵敏度为88%，特异性为83.1%。新的简化综合评分系统将PET/CT结果与2012年ACR/EULAR临床分类标准相结合，简化了评分组件，提高了诊断性能和临床效用，从而使风湿病学家在临床环境中更容易获得和实用。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Seminars in arthritis and rheumatism 医学-风湿病学

CiteScore

9.20

自引率

4.00%

发文量

176

审稿时长

46 days

期刊介绍： Seminars in Arthritis and Rheumatism provides access to the highest-quality clinical, therapeutic and translational research about arthritis, rheumatology and musculoskeletal disorders that affect the joints and connective tissue. Each bimonthly issue includes articles giving you the latest diagnostic criteria, consensus statements, systematic reviews and meta-analyses as well as clinical and translational research studies. Read this journal for the latest groundbreaking research and to gain insights from scientists and clinicians on the management and treatment of musculoskeletal and autoimmune rheumatologic diseases. The journal is of interest to rheumatologists, orthopedic surgeons, internal medicine physicians, immunologists and specialists in bone and mineral metabolism.