Scientific letter
Usefulness of positron emission tomography with 18F-fluorodeoxyglucose in Still's disease
Utilidad de la tomografía por emisión de positrones con 18F-fluorodeoxiglucosa en la enfermedad de Still
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"identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "Luis Felipe" "apellidos" => "Rosel Rioja" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Rafael" "apellidos" => "Ramírez Lasanta" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Medicina Nuclear, Fundación Rioja Salud, Centro de Investigación Biomédica de La Rioja (CIBIR), Hospital San Pedro, Logroño, La Rioja, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Medicina Interna, Hospital San Pedro, Logroño, La Rioja, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Utilidad de la tomografía por emisión de positrones con <span class="elsevierStyleSup">18</span>F-fluorodeoxiglucosa en la enfermedad de Still" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1437 "Ancho" => 700 "Tamanyo" => 72787 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronal view of <span class="elsevierStyleSup">18</span>FDG PET showing bilateral axillary hypermetabolic lymph node foci (thin arrows) and increased activity in spleen (thick arrow) and bone marrow (arrowheads).</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">The contribution of <span class="elsevierStyleSup">18</span>F-fluorodeoxyglucose (FDG) PET in non-oncological diseases has attracted increasing attention in recent years. The usefulness of the technique in the study of patients with fever of unknown origin, and inflammatory and granulomatous diseases has been proven. We had already published the value of PET in the diagnosis, assessment of the extent and response to treatment in cases of Takayasu's arteritis.<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">1</span></a> On this occasion, we have reviewed our recent case series in 8 patients diagnosed with adult Still. 4 cases underwent a FDG PET following routine protocol to guide the diagnosis and rule out lymphoma.</p><p id="par0010" class="elsevierStylePara elsevierViewall">The series includes a male and 3 females, with a mean age of 43.5 years (range 21–81 years). Pharyngeal pain and typical salmon-pink maculopapular skin <span class="elsevierStyleItalic">rash</span> was identified in all patients. Three patients had fever, 2 of them with lymphadenopathy on physical examination. The fourth patient only had multiple lymph nodes. Three patients complained about small joint arthralgia or arthromyalgia in both hands or generalized. PET scan performed in patients showed nodal foci with different extension and moderate activity (SUV: 4.3–3.4) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The spleen showed diffuse uptake in nearly all patients (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). The increase in bone activity was visualized in 3 of the 4 patients, diffuse and predominantly in axial skeleton (SUV: 2.9–2.7) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0015" class="elsevierStylePara elsevierViewall">The first articles on the contribution of inflammatory tissue in FDG uptake in tumour mass were published more than 20 years ago. Up to 29% of the visualized activity in the tumour mass is generated by the inflammatory tissue, macrophages and granulation tissue.<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">2</span></a> This aroused interest in the technique's contribution in favour of these non-oncologic diseases, useful for assessing the degree of inflammatory activity, extent and response to treatment.</p><p id="par0020" class="elsevierStylePara elsevierViewall">The low prevalence of the Still's disease explains the small number of publications on the value of FDG PET in this disease. The experience is greater in Eastern countries. Most papers report isolated cases and include details of PET scan findings or images of interest. Dong et al.<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">3</span></a> recently published one of the papers with the largest series (26 patients). Joint uptake is rare and occurs in less than 50% of symptomatic patients. This fact would explain the lack of joint findings in the PET scan performed to our patients. FDG deposits in small and/or large joints have been described in isolated cases. An outstanding case has been recently published which highlighted polyarticular involvement and increased bone activity.<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">4</span></a> Bone marrow tracer uptake is justified by a hyperplasia of the same. This suggests that FDG uptake reflects increased bone marrow metabolism in these circumstances, rather than an actual involvement. A characteristic fact that we observe in these cases is that the tracer uptake shows a diffuse pattern, of homogeneous distribution, particularly in the axial skeleton and proximal third of humerus and femur. In one of our patients, the oldest one, bone marrow uptake was not excessive; it could be related to the replacement of bone marrow by yellow marrow.</p><p id="par0025" class="elsevierStylePara elsevierViewall">Splenic activity was increased in all our patients (SUV: 5.5–2.7) and hepatosplenic index was inverted in the same patients. There was no splenomegaly in any of them. Macrophage infiltration in these structures is the cause of hepatosplenic uptake. There is little correlation between FDG deposit activities (SUV) and laboratory abnormalities, except a significant correlation between LDH and SUV of the spleen.</p><p id="par0030" class="elsevierStylePara elsevierViewall">FDG PET/CT's capacity to establish degrees of inflammatory activity has been proposed as a treatment assessment tool. Choe et al.<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">5</span></a> reported about 2 patients who were treated with a regimen of corticosteroids and who achieved an adequate response from a clinical and laboratory perspective, only one of them achieved a resolution in uptake abnormalities, while the other still presented foci of mild activity in thoracic lymph nodes after 15 months of follow-up; these findings confirm that FDG PET/CT should be considered as the assessment tool and its negativity as remission criteria.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Cabrera Villegas A, Rosel Rioja LF, Ramírez Lasanta R. Utilidad de la tomografía por emisión de positrones con <span class="elsevierStyleSup">18</span>F-fluorodeoxiglucosa en la enfermedad de Still. Med Clin (Barc). 2017;148:140–141.</p>" ] ] "multimedia" => array:1 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1437 "Ancho" => 700 "Tamanyo" => 72787 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Coronal view of <span class="elsevierStyleSup">18</span>FDG PET showing bilateral axillary hypermetabolic lymph node foci (thin arrows) and increased activity in spleen (thick arrow) and bone marrow (arrowheads).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0030" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "PET-CT with <span class="elsevierStyleSup">18</span>F-FDG in the diagnosis of Takayasu's arteritis and the assessment of response to therapy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "A. Cabrera" 1 => "A.L. Caicedo" 2 => "A. Elena" 3 => "M.P. Garrastachu" 4 => "F. Cañete" 5 => "R. Ramírez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2013.11.006" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol" "fecha" => "2014" "volumen" => "33" "paginaInicial" => "302" "paginaFinal" => "305" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24950891" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0035" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "R. Kubota" 1 => "S. Yamada" 2 => "K. Kubota" 3 => "K. Ishiwata" 4 => "N. Tamahashi" 5 => "T. Ido" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Nucl Med" "fecha" => "1992" "volumen" => "33" "paginaInicial" => "1972" "paginaFinal" => "1980" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/1432158" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0040" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT in patients with adult-onset Still's disease" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "M.J. Dong" 1 => "C.G. Wang" 2 => "K. Zhao" 3 => "G.L. Wang" 4 => "M.L. Sun" 5 => "Z.F. Liu" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s10067-015-2901-6" "Revista" => array:6 [ "tituloSerie" => "Clin Rheumatol" "fecha" => "2015" "volumen" => "34" "paginaInicial" => "2047" "paginaFinal" => "2056" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25711875" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0045" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "<span class="elsevierStyleSup">18</span>F-FDG PET/CT aids the diagnosis of adult onset Still's disease in a patient with fever of unknown origin" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "S.G. Roy" 1 => "S. Karunanithi" 2 => "V.S. Dhull" 3 => "C. Bal" 4 => "R. Kumar" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.remn.2014.03.001" "Revista" => array:6 [ "tituloSerie" => "Rev Esp Med Nucl Imagen Mol" "fecha" => "2014" "volumen" => "33" "paginaInicial" => "392" "paginaFinal" => "393" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/25242172" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0050" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical significance of <span class="elsevierStyleSup">18</span>F-fluoro-dexoxyglucose positron emission tomography in patients with adult-onset Still's disease: Report of two cases and review of literatures" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "J.Y. Choe" 1 => "D.S. Chung" 2 => "S.H. Park" 3 => "H.H. Kwon" 4 => "S.K. 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