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Detection of Subclinical Synovitis with Macrophage Targeting and Positron Emission Tomography in Patients with Rheumatoid Arthritis without Clinical Arthritis
- Source :
- Gent, Y, Ahmadi, N, Voskuyl, A E, Hoetjes, N J, van Kuijk, C, Britsemmer, K, Turkstra, F, Boers, M, Hoekstra, O S & van der Laken, C J 2014, ' Detection of Subclinical Synovitis with Macrophage Targeting and Positron Emission Tomography in Patients with Rheumatoid Arthritis without Clinical Arthritis ', Journal of Rheumatology, vol. 41, no. 11, pp. 2145-2152 . https://doi.org/10.3899/jrheum.140059, Journal of Rheumatology, 41(11), 2145-2152. Journal of Rheumatology
- Publication Year :
- 2014
-
Abstract
- Objective.To determine whether macrophage targeting by (R)-11C-PK11195 positron emission tomography (PET) can visualize subclinical joint inflammation in patients with rheumatoid arthritis (RA) without clinical arthritis during or after treatment, with flare as clinical outcome measure.Methods.(R)-11C-PK11195 PET and contrast-enhanced magnetic resonance imaging (MRI) of hands/wrists were performed in 29 patients with RA without clinical arthritis. (R)-11C-PK11195 PET uptake (semiquantitative score 0–3) in metacarpophalangeal, proximal interphalangeal, and wrist joints (i.e., 22 joints per patient) was scored and summed to obtain a cumulative PET score (range 0–66). Rheumatoid Arthritis Magnetic Resonance Imaging Scoring (RAMRIS) was performed on similar joints. Synovitis and bone marrow edema scores (> 1) were summed to obtain a cumulative MRI score (range 0–288). Occurrence of flare was determined during 3-year followup.Results.Flare was observed in 17/29 patients (59%). (R)-11C-PK11195 PET showed enhanced tracer uptake in 16/29 patients (55%), of which 11 (69%) developed a flare. Highest cumulative PET scores (> 6, n = 3) corresponded with highest cumulative MRI scores (> 39) and were related to development of flare in hands/wrists within 6 months. Cumulative PET scores of patients developing a flare were higher than those of patients without a flare [median (interquartile range) 2 (0–4.5) vs 0 (0–1), p < 0.05]. In contrast, no significant differences were found between cumulative MRI scores of patients with and without a flare.Conclusion.(R)-11C-PK11195 PET showed enhanced uptake, pointing to presence of subclinical synovitis in over half of patients without clinical arthritis. (R)-11C-PK11195 PET may be of value for prediction of exacerbation of RA, since cumulative PET scores > 1 were associated with development of flare within 3 years.
- Subjects :
- Adult
Male
Wrist Joint
medicine.medical_specialty
Exacerbation
Immunology
Arthritis
Contrast Media
Sensitivity and Specificity
Severity of Illness Index
Statistics, Nonparametric
Arthritis, Rheumatoid
Cohort Studies
Rheumatology
Interquartile range
Synovitis
Finger Joint
medicine
Immunology and Allergy
Humans
Prospective Studies
Subclinical infection
Aged
medicine.diagnostic_test
business.industry
Macrophages
Magnetic resonance imaging
Middle Aged
medicine.disease
Isoquinolines
Magnetic Resonance Imaging
Positron emission tomography
Rheumatoid arthritis
Positron-Emission Tomography
Disease Progression
Female
Radiology
business
Nuclear medicine
Follow-Up Studies
Subjects
Details
- ISSN :
- 0315162X
- Database :
- OpenAIRE
- Journal :
- Gent, Y, Ahmadi, N, Voskuyl, A E, Hoetjes, N J, van Kuijk, C, Britsemmer, K, Turkstra, F, Boers, M, Hoekstra, O S & van der Laken, C J 2014, ' Detection of Subclinical Synovitis with Macrophage Targeting and Positron Emission Tomography in Patients with Rheumatoid Arthritis without Clinical Arthritis ', Journal of Rheumatology, vol. 41, no. 11, pp. 2145-2152 . https://doi.org/10.3899/jrheum.140059, Journal of Rheumatology, 41(11), 2145-2152. Journal of Rheumatology
- Accession number :
- edsair.doi.dedup.....9160aca436eecdaa263fc2748528a65f