{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T17:05:58Z","timestamp":1781197558959,"version":"3.54.1"},"reference-count":56,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T00:00:00Z","timestamp":1781136000000},"content-version":"unspecified","delay-in-days":71,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["RMD Open"],"accepted":{"date-parts":[[2026,5,31]]},"published-print":{"date-parts":[[2026,4]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Assessing disease activity in giant cell arteritis (GCA) remains challenging, as existing clinical, laboratory and imaging biomarkers lack specificity. This proof-of-concept study explored the diagnostic potential of vascular adhesion protein-1 (VAP-1) targeting [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-(1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid) DOTA-sialic acid-binding immunoglobulin-like lectin-9 (Siglec-9) positron emission tomography-CT (PET\/CT) as an inflammation-specific molecular imaging biomarker in newly diagnosed and relapsing GCA.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      Patients with newly diagnosed GCA underwent [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-DOTA-Siglec-9 PET\/CT and vascular ultrasound. Tracer uptake (SUVmean\/SUVmax) was quantified in aortic, supra-aortic and extravascular (shoulder\/hip) regions and compared with relapsing patients. Levels of soluble VAP-1 (sVAP-1) and matrix metalloproteinase (MMP)2\/MMP3\/MMP9 were measured in patients and controls as potential biomarkers related to vascular inflammation.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Eight patients with newly diagnosed GCA were compared with eight relapsing patients, alongside eight controls. Imaging revealed a positive association between ultrasound-assessed subclavian artery intima-media thickness and tracer uptake (r=0.67, p=0.035). Prednisolone exposure was inversely associated with vascular uptake across various vascular regions, with SUVmean showing a stronger overall negative association than SUVmax (SUVmean r=\u20130.51, p=0.043; SUVmax r=\u20130.62, p=0.010). Levels of sVAP-1 were reduced in newly diagnosed GCA compared with relapsing patients (p=0.0145) and controls (p=0.0446), and inversely associated with MMP2 (r=\u20130.56, p=0.037) and MMP9 (r=\u20130.47, p=0.089). Notably, MMP2 and MMP3 were negatively associated with vascular uptake (eg, aortic arch: r=\u20130.59, p=0.027).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      This first-in-human study demonstrates that [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-DOTA-Siglec-9 PET\/CT detects vascular inflammation in GCA and shows attenuation with prednisolone exposure. Reduced sVAP-1 levels and inverse associations between MMP2\/MMP3 and tracer uptake support a functional VAP-1\/MMP axis underlying the imaging signal. Our findings further position [\n                      <jats:sup>68<\/jats:sup>\n                      Ga]Ga-DOTA-Siglec-9 PET\/CT as a promising potential molecular imaging biomarker in GCA.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/rmdopen-2025-006633","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T16:40:14Z","timestamp":1781196014000},"page":"e006633","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["[\n                    <sup>68<\/sup>\n                    Ga]Ga-DOTA-Siglec-9 PET\/CT in newly diagnosed giant cell arteritis: an inflammation-specific, treatment-responsive molecular imaging biomarker"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4686-1143","authenticated-orcid":false,"given":"Simon M","family":"Petzinna","sequence":"first","affiliation":[{"name":"Medical Clinic and Polyclinic III 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