Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis

William Y. Raynor, Venkata S. Jonnakuti, Mahdi Zirakchian Zadeh, Thomas J. Werner, Gang Cheng, Hongming Zhuang, Poul Flemming Høilund-Carlsen, Abass Alavi, Joshua F. Baker*

*Kontaktforfatter for dette arbejde

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

Resumé

Aim: 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) can portray increased glycolysis due to inflammation in rheumatoid arthritis (RA). The aim of this study was to evaluate and compare the reliability and construct validity of two methods of quantifying RA disease activity using FDG-PET/CT. Method: Nineteen RA patients and 19 healthy controls matched to sex and age underwent prospective FDG-PET/CT imaging. Metabolic and volumetric metrics were calculated using fixed and adaptive thresholding techniques and partial volume correction. Fixed thresholds segmented regions above average maximum physiological uptake in controls. Differences of means between RA and controls were assessed using t tests, and discrimination was assessed using receiver operating characteristics. Spearman correlation analysis was used to assess associations between FDG-PET/CT measures and clinical assessments of disease activity. Results: All FDG-PET/CT measures were substantially different and nearly non-overlapping between RA and controls (all P <.001). Area under the curve (AUC) for adaptive threshold parameters ranged from 0.986 to 0.997, and AUC for fixed threshold parameters ranged from 0.898 to 0.945. PET parameters were found to correlate positively with various clinical features, namely C-reactive protein, erythrocyte sedimentation rate, interleukin (IL)-6, IL-1, and swollen joint count. Conclusion: All FDG-PET/CT parameters reflecting global RA disease activity differentiated between RA and controls, indicating high clinical utility to diagnose and assess RA. Adaptive thresholds can be used in a wider setting without control data, but methods utilizing fixed thresholds were more reproducible and more closely associated with indications of inflammation.

OriginalsprogEngelsk
TidsskriftInternational Journal of Rheumatic Diseases
Vol/bind22
Udgave nummer12
Sider (fra-til)2191-2198
ISSN1756-1841
DOI
StatusUdgivet - dec. 2019

Fingeraftryk

Area Under Curve
Positron Emission Tomography Computed Tomography
Glycolysis
Reproducibility of Results
ROC Curve
Interleukin-6
Joints

Citer dette

Raynor, W. Y., Jonnakuti, V. S., Zirakchian Zadeh, M., Werner, T. J., Cheng, G., Zhuang, H., ... Baker, J. F. (2019). Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis. International Journal of Rheumatic Diseases, 22(12), 2191-2198. https://doi.org/10.1111/1756-185X.13730
Raynor, William Y. ; Jonnakuti, Venkata S. ; Zirakchian Zadeh, Mahdi ; Werner, Thomas J. ; Cheng, Gang ; Zhuang, Hongming ; Høilund-Carlsen, Poul Flemming ; Alavi, Abass ; Baker, Joshua F. / Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis. I: International Journal of Rheumatic Diseases. 2019 ; Bind 22, Nr. 12. s. 2191-2198.
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title = "Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis",
abstract = "Aim: 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) can portray increased glycolysis due to inflammation in rheumatoid arthritis (RA). The aim of this study was to evaluate and compare the reliability and construct validity of two methods of quantifying RA disease activity using FDG-PET/CT. Method: Nineteen RA patients and 19 healthy controls matched to sex and age underwent prospective FDG-PET/CT imaging. Metabolic and volumetric metrics were calculated using fixed and adaptive thresholding techniques and partial volume correction. Fixed thresholds segmented regions above average maximum physiological uptake in controls. Differences of means between RA and controls were assessed using t tests, and discrimination was assessed using receiver operating characteristics. Spearman correlation analysis was used to assess associations between FDG-PET/CT measures and clinical assessments of disease activity. Results: All FDG-PET/CT measures were substantially different and nearly non-overlapping between RA and controls (all P <.001). Area under the curve (AUC) for adaptive threshold parameters ranged from 0.986 to 0.997, and AUC for fixed threshold parameters ranged from 0.898 to 0.945. PET parameters were found to correlate positively with various clinical features, namely C-reactive protein, erythrocyte sedimentation rate, interleukin (IL)-6, IL-1, and swollen joint count. Conclusion: All FDG-PET/CT parameters reflecting global RA disease activity differentiated between RA and controls, indicating high clinical utility to diagnose and assess RA. Adaptive thresholds can be used in a wider setting without control data, but methods utilizing fixed thresholds were more reproducible and more closely associated with indications of inflammation.",
keywords = "fluorodeoxyglucose, inflammation, positron emission tomography, rheumatoid arthritis, synovitis",
author = "Raynor, {William Y.} and Jonnakuti, {Venkata S.} and {Zirakchian Zadeh}, Mahdi and Werner, {Thomas J.} and Gang Cheng and Hongming Zhuang and H{\o}ilund-Carlsen, {Poul Flemming} and Abass Alavi and Baker, {Joshua F.}",
year = "2019",
month = "12",
doi = "10.1111/1756-185X.13730",
language = "English",
volume = "22",
pages = "2191--2198",
journal = "International Journal of Rheumatic Diseases",
issn = "1756-1841",
publisher = "Wiley-Blackwell Publishing Asia",
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}

Raynor, WY, Jonnakuti, VS, Zirakchian Zadeh, M, Werner, TJ, Cheng, G, Zhuang, H, Høilund-Carlsen, PF, Alavi, A & Baker, JF 2019, 'Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis', International Journal of Rheumatic Diseases, bind 22, nr. 12, s. 2191-2198. https://doi.org/10.1111/1756-185X.13730

Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis. / Raynor, William Y.; Jonnakuti, Venkata S.; Zirakchian Zadeh, Mahdi; Werner, Thomas J.; Cheng, Gang; Zhuang, Hongming; Høilund-Carlsen, Poul Flemming; Alavi, Abass; Baker, Joshua F.

I: International Journal of Rheumatic Diseases, Bind 22, Nr. 12, 12.2019, s. 2191-2198.

Publikation: Bidrag til tidsskriftTidsskriftartikelForskningpeer review

TY - JOUR

T1 - Comparison of methods of quantifying global synovial metabolic activity with FDG-PET/CT in rheumatoid arthritis

AU - Raynor, William Y.

AU - Jonnakuti, Venkata S.

AU - Zirakchian Zadeh, Mahdi

AU - Werner, Thomas J.

AU - Cheng, Gang

AU - Zhuang, Hongming

AU - Høilund-Carlsen, Poul Flemming

AU - Alavi, Abass

AU - Baker, Joshua F.

PY - 2019/12

Y1 - 2019/12

N2 - Aim: 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) can portray increased glycolysis due to inflammation in rheumatoid arthritis (RA). The aim of this study was to evaluate and compare the reliability and construct validity of two methods of quantifying RA disease activity using FDG-PET/CT. Method: Nineteen RA patients and 19 healthy controls matched to sex and age underwent prospective FDG-PET/CT imaging. Metabolic and volumetric metrics were calculated using fixed and adaptive thresholding techniques and partial volume correction. Fixed thresholds segmented regions above average maximum physiological uptake in controls. Differences of means between RA and controls were assessed using t tests, and discrimination was assessed using receiver operating characteristics. Spearman correlation analysis was used to assess associations between FDG-PET/CT measures and clinical assessments of disease activity. Results: All FDG-PET/CT measures were substantially different and nearly non-overlapping between RA and controls (all P <.001). Area under the curve (AUC) for adaptive threshold parameters ranged from 0.986 to 0.997, and AUC for fixed threshold parameters ranged from 0.898 to 0.945. PET parameters were found to correlate positively with various clinical features, namely C-reactive protein, erythrocyte sedimentation rate, interleukin (IL)-6, IL-1, and swollen joint count. Conclusion: All FDG-PET/CT parameters reflecting global RA disease activity differentiated between RA and controls, indicating high clinical utility to diagnose and assess RA. Adaptive thresholds can be used in a wider setting without control data, but methods utilizing fixed thresholds were more reproducible and more closely associated with indications of inflammation.

AB - Aim: 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography/computed tomography (FDG-PET/CT) can portray increased glycolysis due to inflammation in rheumatoid arthritis (RA). The aim of this study was to evaluate and compare the reliability and construct validity of two methods of quantifying RA disease activity using FDG-PET/CT. Method: Nineteen RA patients and 19 healthy controls matched to sex and age underwent prospective FDG-PET/CT imaging. Metabolic and volumetric metrics were calculated using fixed and adaptive thresholding techniques and partial volume correction. Fixed thresholds segmented regions above average maximum physiological uptake in controls. Differences of means between RA and controls were assessed using t tests, and discrimination was assessed using receiver operating characteristics. Spearman correlation analysis was used to assess associations between FDG-PET/CT measures and clinical assessments of disease activity. Results: All FDG-PET/CT measures were substantially different and nearly non-overlapping between RA and controls (all P <.001). Area under the curve (AUC) for adaptive threshold parameters ranged from 0.986 to 0.997, and AUC for fixed threshold parameters ranged from 0.898 to 0.945. PET parameters were found to correlate positively with various clinical features, namely C-reactive protein, erythrocyte sedimentation rate, interleukin (IL)-6, IL-1, and swollen joint count. Conclusion: All FDG-PET/CT parameters reflecting global RA disease activity differentiated between RA and controls, indicating high clinical utility to diagnose and assess RA. Adaptive thresholds can be used in a wider setting without control data, but methods utilizing fixed thresholds were more reproducible and more closely associated with indications of inflammation.

KW - fluorodeoxyglucose

KW - inflammation

KW - positron emission tomography

KW - rheumatoid arthritis

KW - synovitis

U2 - 10.1111/1756-185X.13730

DO - 10.1111/1756-185X.13730

M3 - Journal article

C2 - 31721461

AN - SCOPUS:85075006440

VL - 22

SP - 2191

EP - 2198

JO - International Journal of Rheumatic Diseases

JF - International Journal of Rheumatic Diseases

SN - 1756-1841

IS - 12

ER -