Review Article

Giant Cell Arteritis: A Systematic Review of the Qualitative and Semiquantitative Methods to Assess Vasculitis with 18F-Fluorodeoxyglucose Positron Emission Tomography

Table 1

Current state of scoring methods of 18F-FDG PET in giant cell arteritis.

Author (year)Study designPatientsControlsTechniqueMethod of analysisDescriptionStandard of referenceDiagnostic performance

Blockmans et al. (1999) [25]Prospective1123PETQualitativeVisual grading scaleACR criteria + TABNot specified

Blockmans et al. (2000) [26]Prospective2544PETQualitativeVisual grading scaleClinical symptoms + TABThoracic vessels
Sensitivity: 56%
Specificity: 98%
PPV: 93%
NPV: 80%
Legs
Sensitivity: 64%
Specificity: 77%

Meller et al. (2003) [27]Prospective15Group 1: 38
Group 2: 40
PET and PET/CTQualitativeVisual grading scaleACR criteriaSensitivity: 73%
Specificity: 100%

Bleeker-Rovers et al. (2003) [28]Retrospective22PETQualitativePositive/negativeACR criteriaSensitivity: 77%
Specificity: 100%
PPV: 100%
NPV: 82%

Moosig et al. (2004) [29]Prospective136PETQualitative and semiquantitativePositive/negative and SUV vascular/lung ratioPMR: exclusion of other causes of inflammation + Chuang and Healy criteriaSensitivity: 100%
Specificity: 100%

Brodmann et al. (2004) [30]Prospective22PETQualitativePositive/negativeACR criteria + positive hypoechogenic halo on DUSNot specified

Scheel et al. (2004) [31]Prospective8PET and PET/CTQualitativePositive/negativeClinical symptomsNot specified

Walter et al. (2005) [32]Prospective2026PETQualitativeVisual grading scaleACR criteriaSensitivity: 60%
Specificity: 99.8%
PPV: 99.7%
NPV: 67.9%
Accuracy: 78.6%

Blockmans et al. (2006) [21]Prospective35PETSemiquantitativeVisual grading scaleTABNot specified

Blockmans et al. (2007) [33]Prospective35PETSemiquantitativeVisual grading scalePMR: clinical + negative TABNot specified

Henes et al. (2008) [34]Prospective13PET/CTQualitative and semiquantitativePositive/negative and highest SUVmax vascularClinical and diagnostic work-up (including DUS, MRI, CT, and TAB)Sensitivity: 90%
Specificity: 100%

Hautzel et al. (2008) [35]Prospective18Group 1: 36
Group 2: 18
PETSemiquantitativeHighest SUVmax aorta/liver ratioACR criteria or diagnostic work-up (including DUS, TAB, CT, and MRI)Cut-off: 1.0
Sensitivity: 88.9%
Specificity: 94.4%–95.1%
Accuracy: 91.7%–93.2%
PPV: 78.8%–88.9%
NPV: 95.1%–97.7%

Both et al. (2008) [36]Prospective25PETQualitativeVisual grading scaleBirmingham vasculitis activity score (BVAS.2)Not specified

Lehmann et al. (2011) [37]Retrospective2020PETQualitative and semiquantitativePositive/negative and highest SUVmaxClinical (ACR) diagnosis confirmed by histology or MRI angiographyVisual grading
Sensitivity: 65%
Specificity: 80%
SUVmax (cut-off 1.78)
Sensitivity: 90%
Specificity: 45%

Henes et al. (2011) [38]Retrospective10PET/CTQualitativeVisual grading scaleClinical symptomsNot specified

Hooisma et al. (2012) [39]Retrospective62242PET/CTQualitativePositive/negativeClinical symptomsNot specified

Yamashita et al. (2012) [40]Retrospective2717PET/CTSemiquantitativeVisual grading scalePMR: Chuang et al. and Healy’s criteria; no clinical evidence of temporal arteritisNot specified

Besson et al. (2013) [41] Retrospective33 11 PET/CTSemiquantitative: highest SUVmax arterial/liver ratio ACR criteria + TABMethod C at aortic arch: cut-off value of 1.53
: average SUVmax arterial/liver ratio
: highest SUVmax arterial/lung ratio Sensitivity: 81.8%
: average SUVmax arterial/lung ratio
: highest arterial SUVmax/highest venous SUVmax Specificity: 91%
: average arterial SUVmax/venous blood pool activity

Prieto-González et al. (2014) [24]Prospective3220PET/CTSemiquantitativeHighest SUVmax vascular/liver ratioTABAny vascular territory (cut-off of 1.89)
Sensitivity: 80%
Specificity: 79%
Epiaortic vessels (cut-off of 1.70)
Sensitivity: 81%
Specificity: 79%
Aorta (cut-off 2.25)
Sensitivity: 90%
Specificity: 42%
Aorta (cut-off 2.65)
Sensitivity: 58%
Specificity: 90%