Distinct clinical outcomes of positron emission tomography/computed tomography-based subtypes in treatment-naïve Takayasu arteritis.

IF 1.5 4区医学 Q3 RHEUMATOLOGY

Scandinavian Journal of Rheumatology Pub Date : 2026-07-03 DOI:10.1080/03009742.2026.2677340

T Katakura, T Shirai, Y Ishii, H Sato, H Fujii

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引用次数: 0

Abstract

Objective: Positron emission tomography/computed tomography (PET/CT) enables the visualization of vascular inflammation in Takayasu arteritis (TAK). However, the prognostic significance of PET/CT-based arterial involvement remains unclear. This study aimed to classify the distribution patterns of vascular lesions in treatment-naïve TAK using PET/CT and evaluate their association with clinical outcomes.

Method: Patients with TAK who underwent PET/CT before treatment initiation were retrospectively analysed. Hierarchical clustering was performed based on the distribution of arterial ¹⁸F-fluorodeoxyglucose uptake. The clinical outcomes, including relapse and large-vessel complications, were analysed according to the resulting clusters using survival analyses. Longitudinal changes in PET/CT findings and clinical activity were assessed.

Results: Thirty patients (90% women) were included, with a median follow-up of 4.8 years and median age at diagnosis of 48 years. Three distinct PET/CT-based clusters were identified: thoracic (43%), diffuse (30%), and localized (27%). The diffuse type showed the highest relapse rate 24.1/100 person-years, p = 0.04), whereas the thoracic type tended to be associated with more vascular complications (13.9/100 person-years, p = 0.12). The Numano classification did not always correspond to PET/CT-based clusters or predict clinical outcomes. A PET Vascular Activity Score ≥ 7 was associated with relapse but not with vascular complications. PET/CT activity persisted despite clinical inactivity in some cases, which may cause future relapse.

Conclusion: PET/CT-based classification suggested three distinct TAK subtypes with different clinical outcomes. The diffuse type was significantly associated with relapse, whereas the thoracic type caused vascular complications. PET/CT provided superior risk stratification compared to the conventional classification.

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treatment-naïve高松动脉炎的正电子发射断层扫描/计算机断层扫描亚型的不同临床结果。

目的：正电子发射断层扫描/计算机断层扫描（PET/CT）可以显示高松动脉炎（Takayasu arteritis， TAK）的血管炎症。然而，基于PET/ ct的动脉受累的预后意义尚不清楚。本研究旨在通过PET/CT对treatment-naïve TAK血管病变的分布模式进行分类，并评估其与临床预后的关系。方法：对治疗前行PET/CT检查的TAK患者进行回顾性分析。根据动脉18f -氟脱氧葡萄糖摄取的分布进行分层聚类。临床结果，包括复发和大血管并发症，根据结果聚类使用生存分析进行分析。评估PET/CT表现和临床活动的纵向变化。结果：纳入30例患者（90%为女性），中位随访时间为4.8年，诊断时中位年龄为48岁。我们发现了三种不同的PET/ ct簇：胸部（43%）、弥漫性（30%）和局限性（27%）。弥漫型复发率最高（24.1/100人-年，p = 0.04），胸型复发率较高（13.9/100人-年，p = 0.12）。Numano分类并不总是对应于PET/ ct为基础的簇或预测临床结果。PET血管活动评分≥7与复发相关，但与血管并发症无关。在一些病例中，尽管临床无活动，但PET/CT活动持续存在，可能导致未来复发。结论：基于PET/ ct的分类提示三种不同的TAK亚型，其临床结果不同。弥漫型与复发显著相关，而胸型则引起血管并发症。与传统分类相比，PET/CT提供了更好的风险分层。

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

Scandinavian Journal of Rheumatology 医学-风湿病学

CiteScore

3.70

自引率

4.80%

发文量

审稿时长

6-12 weeks

期刊介绍： Scandinavian Journal of Rheumatology is the official journal of the Scandinavian Society for Rheumatology, a non-profit organization following the statutes of the Scandinavian Society for Rheumatology/Scandinavian Research Foundation. The main objective of the Foundation is to support research and promote information and knowledge about rheumatology and related fields. The annual surplus by running the Journal is awarded to young, talented, researchers within the field of rheumatology.pasting The Scandinavian Journal of Rheumatology is an international scientific journal covering clinical and experimental aspects of rheumatic diseases. The journal provides essential reading for rheumatologists as well as general practitioners, orthopaedic surgeons, radiologists, pharmacologists, pathologists and other health professionals with an interest in patients with rheumatic diseases. The journal publishes original articles as well as reviews, editorials, letters and supplements within the various fields of clinical and experimental rheumatology, including; Epidemiology Aetiology and pathogenesis Treatment and prophylaxis Laboratory aspects including genetics, biochemistry, immunology, immunopathology, microbiology, histopathology, pathophysiology and pharmacology Radiological aspects including X-ray, ultrasonography, CT, MRI and other forms of imaging.