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Research ArticleCLINICAL INVESTIGATIONS

Assessment of Large-Vessel Involvement in Giant Cell Arteritis with 18F-FDG PET: Introducing an ROC-Analysis–Based Cutoff Ratio

Hubertus Hautzel, Oliver Sander, Alexander Heinzel, Matthias Schneider and Hans-Wilhelm Müller
Journal of Nuclear Medicine July 2008, 49 (7) 1107-1113; DOI: https://doi.org/10.2967/jnumed.108.051920
Hubertus Hautzel
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Oliver Sander
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Alexander Heinzel
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Matthias Schneider
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Hans-Wilhelm Müller
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  • FIGURE 1. 
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    FIGURE 1. 

    18F-FDG PET images and SUVmax ratios of selected patients: patient from control group I with no history of atherosclerosis (A), patient from control group I with atherosclerosis of aorta and iliac arteries (confirmed by CT) (B), and GCA patients 3 (C) and 13 (D), both of whom had histologically proven GCA. On axial views, ROIs (black lines) were drawn over aortic arch (A–C) and ascending and descending parts of aorta (D). On coronal and sagittal views, arrows indicate 18F-FDG uptake into aortic vessel wall. Coronal view of B additionally shows uptake into iliac vessel wall.

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    FIGURE 2. 

    (A) ROC analysis comparing GCA group with control group I: at cutoff of 1.0, sensitivity was 88.9% and specificity was 95.1%. (B) Cutoff optimization according to CLSI/NCCLS guidelines.

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    TABLE 1

    GCA Group: Detailed Clinical Patient Data

    Patient no.Age (y)SexVessel-to- liver ratioPositive for ACR criteriaHistologyDuplex sonographyAnemiaLiver enzymes (GGT, AST, or ALT)Final diagnosis
    GCA true-positive patients
     174F0.845Pos.Pos. (scl.)YesElevated
     261M0.934NDPos. (scl.)YesElevated
     361F1.004Pos.Pos. (ax.; br.)NoNormal
     457F1.034NDPos. (scl.; ax.; br.)YesNormal
     574F1.054NDPos. (scl.; ax.; br.)NDElevated
     664F1.093NDNDYesElevated
     767F1.093NDPos. (car.; scl.; ax.)YesNormal
     864F1.124Pos.Pos. (scl.; ax.)YesElevated
     962F1.145Pos.Pos. (scl.; ax.)NoNormal
     1062F1.154NDPos. (temp.)NoNormal
     1174F1.185Pos.Pos. (temp.)NoNormal
     1264F1.195Pos.Neg.NoElevated
     1356F1.244Pos.Pos. (car.)YesNormal
     1467F1.263NDNeg.YesNormal
     1565F1.335Pos.Pos. (car.; scl.; ax.)YesElevated
     1665M1.433NDNDYesNormal
     1763M1.873NDPos. (ax.; br.)YesNormal
     1857F1.883NDPos. (scl.)NDNormal
    GCA true-negative patients
     1960F0.793NDNeg.YesElevatedRheumatoid arthritis
     2067M0.833NDNeg.YesNormalParaneoplastic syndrome
     2176F0.843NDNeg.YesElevatedNo diagnosis
     2259F0.853NDNeg.NoNormalNo diagnosis
     2359F0.883NDNeg.NoNormalPolymyalgia rheumatica
    • pos. = positive; neg. = negative; ND = not done; scl. = arteria subclavia; ax. = arteria axillaris; br. = arteria brachialis. car. = arteria carotis; temp. = arteria temporalis.

    • All patients had elevated erythrocyte sedimentation rate/C-reactive protein.

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Journal of Nuclear Medicine: 49 (7)
Journal of Nuclear Medicine
Vol. 49, Issue 7
July 2008
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Assessment of Large-Vessel Involvement in Giant Cell Arteritis with 18F-FDG PET: Introducing an ROC-Analysis–Based Cutoff Ratio
Hubertus Hautzel, Oliver Sander, Alexander Heinzel, Matthias Schneider, Hans-Wilhelm Müller
Journal of Nuclear Medicine Jul 2008, 49 (7) 1107-1113; DOI: 10.2967/jnumed.108.051920

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Assessment of Large-Vessel Involvement in Giant Cell Arteritis with 18F-FDG PET: Introducing an ROC-Analysis–Based Cutoff Ratio
Hubertus Hautzel, Oliver Sander, Alexander Heinzel, Matthias Schneider, Hans-Wilhelm Müller
Journal of Nuclear Medicine Jul 2008, 49 (7) 1107-1113; DOI: 10.2967/jnumed.108.051920
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