Evidence map›Paper›PMID 37115211›Full record

ArticleEuropean journal of nuclear medicine and molecular imaging2023

Development of a simple standardized scoring system for assessing large vessel vasculitis by 18F-FDG PET-CT and differentiation from atherosclerosis.

Y A A Bacour, M P van Kanten, F Smit, E F I Comans, M Akarriou, H C W de Vet, A E Voskuyl, C J van der Laken, Y M Smulders

Open access · hybridAbstract read
In one paragraph

Article in European journal of nuclear medicine and molecular imaging, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.1field-weighted citation impact, top 13% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 8 citations in OpenAlex.

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  5. New thresholds in semi-quantitative [European journal of nuclear medicine and molecular imaging · 2023
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 6 institutions in 1 country.

Y A A BacourDepartment of Internal Medicine, Amsterdam University Medical Center, Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands.
M P van KantenDepartment of Internal Medicine, Amsterdam University Medical Center, Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands.
F SmitDepartment of Radiology and Nuclear Medicine, Alrijne Hospital, Simon, Smitweg 1, 2353GA, Leiderdorp, The Netherlands.
E F I ComansDepartment of Radiology and Nuclear Medicine, Amsterdam University Medical Center, PO Box 7057, Amsterdam 1007MB, Amsterdam, The Netherlands.
M AkarriouDepartment of Radiology and Nuclear Medicine, Spaarne Hospital, PO Box 770, Hoofddorp, 2130AT, The Netherlands.
H C W de VetDepartment of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, VrijeUniversiteit Amsterdam, Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands.
A E VoskuylAmsterdam UMC-Location VUmc, Amsterdam Rheumatology and Immunology Center (ARC), Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands.
C J van der LakenAmsterdam UMC-Location VUmc, Amsterdam Rheumatology and Immunology Center (ARC), Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands.
Y M SmuldersDepartment of Internal Medicine, Amsterdam University Medical Center, Amsterdam 1007MB, PO Box 7057, Amsterdam, The Netherlands. y.smulders@amsterdamumc.nl.
Amsterdam UMC Location VUmc · NLUniversity of Amsterdam · NLAlrijne Ziekenhuis · NLAmsterdam University Medical Centers · NLSpaarne Ziekenhuis · NLVrije Universiteit Amsterdam · NL

Funding

Dutch Arthritis Association 13-1-101
6 · The paper itself

Abstract

purposeThis study is to develop a structured approach to distinguishing large-artery vasculitis from atherosclerosis using 18-fluorodeoxyglucose positron emission tomography combined with low-dose computed tomography (FDG PET/CT).

methodsFDG PET/CT images of 60 patients were evaluated, 30 having biopsy-proven giant cell arteritis (GCA; the most common form of large-artery vasculitis), and 30 with severe atherosclerosis. Images were evaluated by 12 nuclear medicine physicians using 5 criteria: FDG uptake pattern (intensity, distribution, circularity), the degree of calcification, and co-localization of calcifications with FDG-uptake. Criteria that passed agreement, and reliability tests were subsequently analysed for accuracy using receiver operator curve (ROC) analyses. Criteria that showed discriminative ability were then combined in a multi-component scoring system. Both initial and final 'gestalt' conclusion were also reported by observers before and after detailed examination of the images.

resultsAgreement and reliability analyses disqualified 3 of the 5 criteria, leaving only FDG uptake intensity compared to liver uptake and arterial wall calcification for potential use in a scoring system. ROC analysis showed an area under the curve (AUC) of 0.90 (95%CI 0.87-0.92) for FDG uptake intensity. Degree of calcification showed poor discriminative ability on its own (AUC of 0.62; 95%CI 0.58-0.66). When combining presence of calcification with FDG uptake intensity into a 6-tiered scoring system, the AUC remained similar at 0.91 (95%CI 0.88-0.93). After exclusion of cases with arterial prostheses, the AUC increased to 0.93 (95%CI 0.91-0.95). The accuracy of the 'gestalt' conclusion was initially 89% (95%CI 86-91%) and increased to 93% (95%CI 91-95%) after detailed image examination.

conclusionStandardised assessment of arterial wall FDG uptake intensity, preferably combined with assessment of arterial calcifications into a scoring method, enables accurate, but not perfect, distinction between large artery vasculitis and atherosclerosis.

Indexed as

ArteritisAtherosclerosisGiant Cell ArteritisCell DifferentiationFluorodeoxyglucose F18HumansPositron-Emission TomographyPositron Emission Tomography Computed TomographyRadiopharmaceuticalsReproducibility of ResultsFluorodeoxyglucose F18Radiopharmaceuticals18-Fluorodeoxyglucose positron emission tomographyAtherosclerosisComputed tomographyDiagnosisVasculitis

Identifiers

PMID37115211
PMCPMC10317865
OpenAlexW4367307849

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.