Konstanze V Guggenberger, Marius L Vogt, Steven P Rowe, Takahiro Higuchi, Marc Schmalzing, Hans-Peter Tony, Andreas K Buck, Thorsten A Bley, Matthias Fröhlich, Rudolf A Werner
{"title":"c反应蛋白和白细胞计数在巨细胞动脉炎患者FDG PET/CT诊断中的临床应用[18F]。","authors":"Konstanze V Guggenberger, Marius L Vogt, Steven P Rowe, Takahiro Higuchi, Marc Schmalzing, Hans-Peter Tony, Andreas K Buck, Thorsten A Bley, Matthias Fröhlich, Rudolf A Werner","doi":"10.1055/a-1830-7767","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>2-deoxy-2-[<sup>18</sup>F]fluoro-D-glucose ([<sup>18</sup>F]FDG) PET/CT can be utilized in patients with giant cell arteritis (GCA), but pretest probability of established laboratory marker such as C-reactive protein (CRP) and white blood cell count (WBC) has not been defined yet. We aimed to elucidate the clinical utility of CRP and WBC for scheduling an [<sup>18</sup>F]FDG scan.</p><p><strong>Methods: </strong>18 treatment-naïve GCA patients and 14 GCA subjects with anti-inflammatory treatment (glucocorticoids or comparable drugs), who underwent [<sup>18</sup>F]FDG PET/CT and who had no other inflammatory disease at time of scan, were identified. A semi-quantitative analysis in 11 vessel segments was conducted, with averaged jugular vein, healthy liver and lung tissue (Target-to-background ratio [TBR]<sub>VJ/liver/lung</sub>) serving as background. Derived TBR were then correlated with CRP and WBC at time of PET using Spearman's correlation.</p><p><strong>Results: </strong>For all treatment-naïve patients, TBR<sub>VJ</sub> was 2.3±1.1 (95%CI, 2.2-2.5), TBR<sub>liver</sub> was 1.0±0.5 (95%CI, 0.9-1.0) and average TBR<sub>lung</sub> was 6.3±3.6 (95%CI, 5.8-6.8). No significant correlation was noted for either CRP (TBR<sub>VJ</sub>: R=-0.19; TBR<sub>liver</sub>: R=-0.03; TBR<sub>lung</sub>: R=-0.17; each P ≥ 0.44) or for WBC (TBR<sub>VJ</sub>: R=-0.40; TBR<sub>liver</sub>: R=-0.32; TBR<sub>lung</sub>: R=-0.37; each P ≥ 0.10). Similar results were recorded for patients under treatment at time of PET. Again, no significant correlation was reached for either CRP (TBR<sub>VJ</sub>: R=-0.17; TBR<sub>liver</sub>: R=-0.28; TBR<sub>lung</sub>: R=-0.09; each P ≥ 0.32) or WBC (TBR<sub>VJ</sub>: R=-0.06; TBR<sub>liver</sub>: R=-0.13; TBR<sub>lung</sub>: R=0.06; each P ≥ 0.65).</p><p><strong>Conclusions: </strong>In GCA patients with and without anti-inflammatory treatment, CRP and WBC did not substantially correlate with TBR at time of scan. Given the rather limited pretest probability of those parameters, such laboratory values may have less diagnostic utility to order an [<sup>18</sup>F]FDG PET/CT.</p>","PeriodicalId":19238,"journal":{"name":"Nuklearmedizin-nuclear Medicine","volume":null,"pages":null},"PeriodicalIF":1.0000,"publicationDate":"2022-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"1","resultStr":"{\"title\":\"Clinical Utility of C-Reactive Protein and White Blood Cell Count for Scheduling an [18F]FDG PET/CT in Patients with Giant Cell Arteritis.\",\"authors\":\"Konstanze V Guggenberger, Marius L Vogt, Steven P Rowe, Takahiro Higuchi, Marc Schmalzing, Hans-Peter Tony, Andreas K Buck, Thorsten A Bley, Matthias Fröhlich, Rudolf A Werner\",\"doi\":\"10.1055/a-1830-7767\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>2-deoxy-2-[<sup>18</sup>F]fluoro-D-glucose ([<sup>18</sup>F]FDG) PET/CT can be utilized in patients with giant cell arteritis (GCA), but pretest probability of established laboratory marker such as C-reactive protein (CRP) and white blood cell count (WBC) has not been defined yet. We aimed to elucidate the clinical utility of CRP and WBC for scheduling an [<sup>18</sup>F]FDG scan.</p><p><strong>Methods: </strong>18 treatment-naïve GCA patients and 14 GCA subjects with anti-inflammatory treatment (glucocorticoids or comparable drugs), who underwent [<sup>18</sup>F]FDG PET/CT and who had no other inflammatory disease at time of scan, were identified. A semi-quantitative analysis in 11 vessel segments was conducted, with averaged jugular vein, healthy liver and lung tissue (Target-to-background ratio [TBR]<sub>VJ/liver/lung</sub>) serving as background. Derived TBR were then correlated with CRP and WBC at time of PET using Spearman's correlation.</p><p><strong>Results: </strong>For all treatment-naïve patients, TBR<sub>VJ</sub> was 2.3±1.1 (95%CI, 2.2-2.5), TBR<sub>liver</sub> was 1.0±0.5 (95%CI, 0.9-1.0) and average TBR<sub>lung</sub> was 6.3±3.6 (95%CI, 5.8-6.8). No significant correlation was noted for either CRP (TBR<sub>VJ</sub>: R=-0.19; TBR<sub>liver</sub>: R=-0.03; TBR<sub>lung</sub>: R=-0.17; each P ≥ 0.44) or for WBC (TBR<sub>VJ</sub>: R=-0.40; TBR<sub>liver</sub>: R=-0.32; TBR<sub>lung</sub>: R=-0.37; each P ≥ 0.10). Similar results were recorded for patients under treatment at time of PET. Again, no significant correlation was reached for either CRP (TBR<sub>VJ</sub>: R=-0.17; TBR<sub>liver</sub>: R=-0.28; TBR<sub>lung</sub>: R=-0.09; each P ≥ 0.32) or WBC (TBR<sub>VJ</sub>: R=-0.06; TBR<sub>liver</sub>: R=-0.13; TBR<sub>lung</sub>: R=0.06; each P ≥ 0.65).</p><p><strong>Conclusions: </strong>In GCA patients with and without anti-inflammatory treatment, CRP and WBC did not substantially correlate with TBR at time of scan. Given the rather limited pretest probability of those parameters, such laboratory values may have less diagnostic utility to order an [<sup>18</sup>F]FDG PET/CT.</p>\",\"PeriodicalId\":19238,\"journal\":{\"name\":\"Nuklearmedizin-nuclear Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":1.0000,\"publicationDate\":\"2022-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"1\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Nuklearmedizin-nuclear Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1055/a-1830-7767\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2022/8/17 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Nuklearmedizin-nuclear Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1055/a-1830-7767","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2022/8/17 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING","Score":null,"Total":0}
引用次数: 1
摘要
目的:2-脱氧-2-[18F]氟-d -葡萄糖([18F]FDG) PET/CT可用于巨细胞动脉炎(GCA)患者，但尚未确定已建立的实验室标志物如c反应蛋白(CRP)和白细胞计数(WBC)的预测概率。我们的目的是阐明CRP和WBC在安排[18F]FDG扫描中的临床应用。方法:选取18例treatment-naïve GCA患者和14例接受抗炎治疗(糖皮质激素或类似药物)的GCA患者，均行[18F]FDG PET/CT扫描，扫描时无其他炎症性疾病。以平均颈静脉、健康肝脏和肺组织(目标与背景比[TBR]VJ/肝/肺)为背景，对11个血管段进行半定量分析。然后用Spearman相关法将所得TBR与PET时的CRP和WBC进行相关性分析。结果:在所有treatment-naïve患者中，TBRVJ为2.3±1.1 (95%CI, 2.2-2.5)， TBRliver为1.0±0.5 (95%CI, 0.9-1.0)， TBRlung平均为6.3±3.6 (95%CI, 5.8-6.8)。两组CRP均无显著相关性(TBRVJ: R=-0.19;TBRliver: R = -0.03;TBRlung: R = -0.17;每个P≥0.44)或WBC (TBRVJ: R=-0.40;TBRliver: R = -0.32;TBRlung: R = -0.37;P均≥0.10)。同样的结果也被记录在PET时接受治疗的患者身上。同样，CRP (TBRVJ: R=-0.17;TBRliver: R = -0.28;TBRlung: R = -0.09;P均≥0.32)或WBC (TBRVJ: R=-0.06;TBRliver: R = -0.13;TBRlung: R = 0.06;P均≥0.65)。结论:在接受和未接受抗炎治疗的GCA患者中，扫描时CRP和WBC与TBR无显著相关性。考虑到这些参数的预测概率相当有限，这些实验室值可能对订购FDG PET/CT的诊断效用较小[18F]。
Clinical Utility of C-Reactive Protein and White Blood Cell Count for Scheduling an [18F]FDG PET/CT in Patients with Giant Cell Arteritis.
Objectives: 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) PET/CT can be utilized in patients with giant cell arteritis (GCA), but pretest probability of established laboratory marker such as C-reactive protein (CRP) and white blood cell count (WBC) has not been defined yet. We aimed to elucidate the clinical utility of CRP and WBC for scheduling an [18F]FDG scan.
Methods: 18 treatment-naïve GCA patients and 14 GCA subjects with anti-inflammatory treatment (glucocorticoids or comparable drugs), who underwent [18F]FDG PET/CT and who had no other inflammatory disease at time of scan, were identified. A semi-quantitative analysis in 11 vessel segments was conducted, with averaged jugular vein, healthy liver and lung tissue (Target-to-background ratio [TBR]VJ/liver/lung) serving as background. Derived TBR were then correlated with CRP and WBC at time of PET using Spearman's correlation.
Results: For all treatment-naïve patients, TBRVJ was 2.3±1.1 (95%CI, 2.2-2.5), TBRliver was 1.0±0.5 (95%CI, 0.9-1.0) and average TBRlung was 6.3±3.6 (95%CI, 5.8-6.8). No significant correlation was noted for either CRP (TBRVJ: R=-0.19; TBRliver: R=-0.03; TBRlung: R=-0.17; each P ≥ 0.44) or for WBC (TBRVJ: R=-0.40; TBRliver: R=-0.32; TBRlung: R=-0.37; each P ≥ 0.10). Similar results were recorded for patients under treatment at time of PET. Again, no significant correlation was reached for either CRP (TBRVJ: R=-0.17; TBRliver: R=-0.28; TBRlung: R=-0.09; each P ≥ 0.32) or WBC (TBRVJ: R=-0.06; TBRliver: R=-0.13; TBRlung: R=0.06; each P ≥ 0.65).
Conclusions: In GCA patients with and without anti-inflammatory treatment, CRP and WBC did not substantially correlate with TBR at time of scan. Given the rather limited pretest probability of those parameters, such laboratory values may have less diagnostic utility to order an [18F]FDG PET/CT.
期刊介绍：
Als Standes- und Fachorgan (Organ von Deutscher Gesellschaft für Nuklearmedizin (DGN), Österreichischer Gesellschaft für Nuklearmedizin und Molekulare Bildgebung (ÖGN), Schweizerischer Gesellschaft für Nuklearmedizin (SGNM, SSNM)) von hohem wissenschaftlichen Anspruch befasst sich die CME-zertifizierte Nuklearmedizin/ NuclearMedicine mit Diagnostik und Therapie in der Nuklearmedizin und dem Strahlenschutz: Originalien, Übersichtsarbeiten, Referate und Kongressberichte stellen aktuelle Themen der Diagnose und Therapie dar.
Ausführliche Berichte aus den DGN-Arbeitskreisen, Nachrichten aus Forschung und Industrie sowie Beschreibungen innovativer technischer Geräte, Einrichtungen und Systeme runden das Konzept ab.
Die Abstracts der Jahrestagungen dreier europäischer Fachgesellschaften sind Bestandteil der Kongressausgaben.
Nuklearmedizin erscheint regelmäßig mit sechs Ausgaben pro Jahr und richtet sich vor allem an Nuklearmediziner, Radiologen, Strahlentherapeuten, Medizinphysiker und Radiopharmazeuten.
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