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Fludeoxyglucose Positron Emission Tomography in the Diagnosis of Giant Cell Arteritis
Alla Turlakow, MD;
Henry W. D. Yeung, MD;
John Pui, MD;
Homer Macapinlac, MD;
Evan Liebovitz, MD;
Valerie Rusch, MD;
Andre Goy, MD;
Steven M. Larson, MD
Arch Intern Med. 2001;161:1003-1007.
We describe a case in which fludeoxyglucose F 18 positron emission tomography
(PET) led directly to the diagnosis of giant cell arteritis in an elderly
woman with a fever of unknown origin.The patient presented with a 3-month
history of fatigue, fever, headache, visual disturbance, jaw claudication,
and anemia. A computed tomographic scan showed an anterior mediastinal mass
that was suspected of being malignant. A fludeoxyglucose F 18 PET scan performed
for preoperative evaluation identified striking uptake of fludeoxyglucose
F 18 in the walls of the entire aorta, left main coronary artery, and subclavian,
carotid, and common iliac arteries bilaterally, suggestive of an arteritis,
a diagnosis subsequently confirmed by the findings of an arterial biopsy.
Her erythrocyte sedimentation rate was 129 mm/h. There was normalizaton of
the PET scan 2 weeks following treatment with prednisolone. This case suggests
that fludeoxyglucose F 18 PET contributes to the noninvasive diagnosis of
giant cell arteritis, as well as to the evaluation of the extent of disease,
response to therapy, and disease recurrence.
From the Nuclear Medicine Service (Drs Turlakow, Yeung, Macapinlac,
and Larson) and the Departments of Pathology (Dr Pui), Surgery (Dr Rusch),
and Hematology (Dr Goy), Memorial Sloan-Kettering Cancer Center, New York,
NY; and the Department of Rheumatology, New York Presbyterian Hospital, Cornell
Campus, New York (Dr Liebovitz).
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