ArticleClinical rheumatology2026
The real-world experience of combined cranial and large vessel
Article in Clinical rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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10 authors.
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Abstract
introductionFDG-PET/CT offers high diagnostic accuracy in research settings for GCA, a systemic medium-large vessel vasculitis (M-LVV). We aimed to analyse its diagnostic performance in a real-world clinical setting.
methodsWe audited all patients investigated with FDG-PET/CT for suspected new onset GCA between July 2019 and March 2022, at a single tertiary institution in Australia. Data was collected from patient and physician questionnaires, and scan reports describing FDG activity in cranial, supra-aortic, aortic and infra-aortic vascular territories, and the overall interpretation of the scan. The gold standard comparator in analysis was the unblinded treating physician's clinical diagnosis at a minimum of 6 months after the scan.
resultsOne hundred thirty-five patients had an FDG-PET/CT as part of routine care in the investigation of suspected GCA. Forty-four (32.6%) patients had a clinical diagnosis of M-LVV. Thirty-five (26%) scans were reported as positive, 27 (20%) equivocal and 73 (54%) negative for active M-LVV. Diagnostic performance of FDG-PET/CT was dependent on the treatment of equivocal scans in binary analysis, with sensitivity ranging from 77.3 to 90.9% and specificity ranging from 75.8 to 98.9%. In cases with a clinical diagnosis of M-LVV, the supra-aortic territory was metabolically active in 31 (70.5%) and three had metabolic activity isolated to either the cranial or aortic regions.
conclusionsCombined cranial and large vessel FDG-PET/CT shows good diagnostic performance for GCA in a real-world setting. The supra-aortic territory was most commonly active in patients with M-LVV, yet assessment of all territories was required to maximise scan performance. Key Points • FDG-PET/CT has good diagnostic performance for GCA in the real-world setting. • Assessment of both cranial and large vessels is necessary to maximise FDG-PET/CT performance. • Equivocal FDG-PET/CT scans (20% of cases) can be further evaluated with ultrasound and/or biopsy.
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