{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:30:28Z","timestamp":1760236228366,"version":"build-2065373602"},"reference-count":43,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T00:00:00Z","timestamp":1636416000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001659","name":"Deutsche Forschungsgemeinschaft","doi-asserted-by":"publisher","award":["HI 1789\/3-3"],"award-info":[{"award-number":["HI 1789\/3-3"]}],"id":[{"id":"10.13039\/501100001659","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100012330","name":"Okayama University","doi-asserted-by":"publisher","award":["RECTOR Program"],"award-info":[{"award-number":["RECTOR Program"]}],"id":[{"id":"10.13039\/501100012330","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001691","name":"Japan Society for the Promotion of Science","doi-asserted-by":"publisher","award":["JP15K21774"],"award-info":[{"award-number":["JP15K21774"]}],"id":[{"id":"10.13039\/501100001691","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>The 2-deoxy-d-[18F]fluoro-D-glucose (FDG) positron emission tomography\/computed tomography (PET\/CT) is widely utilized to assess the vascular and articular inflammatory burden of patients with a suspected diagnosis of rheumatic disease. We aimed to elucidate the impact of [18F]FDG PET\/CT on change in initially suspected diagnosis in patients at the time of the scan. Thirty-four patients, who had undergone [18F]FDG PET\/CT, were enrolled and the initially suspected diagnosis prior to [18F]FDG PET\/CT was compared to the final diagnosis. In addition, a semi-quantitative analysis including vessel wall-to-liver (VLR) and joint-to-liver (JLR) ratios was also conducted. Prior to [18F]FDG PET\/CT, 22\/34 (64.7%) of patients did not have an established diagnosis, whereas in 7\/34 (20.6%), polymyalgia rheumatica (PMR) was suspected, and in 5\/34 (14.7%), giant cell arteritis (GCA) was suspected by the referring rheumatologists. After [18F]FDG PET\/CT, the diagnosis was GCA in 19\/34 (55.9%), combined GCA and PMR (GCA + PMR) in 9\/34 (26.5%) and PMR in the remaining 6\/34 (17.6%). As such, [18F]FDG PET\/CT altered suspected diagnosis in 28\/34 (82.4%), including in all unclear cases. VLR of patients whose final diagnosis was GCA tended to be significantly higher when compared to VLR in PMR (GCA, 1.01 \u00b1 0.08 (95%CI, 0.95\u20131.1) vs. PMR, 0.92 \u00b1 0.1 (95%CI, 0.85\u20130.99), p = 0.07), but not when compared to PMR + GCA (1.04 \u00b1 0.14 (95%CI, 0.95\u20131.13), p = 1). JLR of individuals finally diagnosed with PMR (0.94 \u00b1 0.16, (95%CI, 0.83\u20131.06)), however, was significantly increased relative to JLR in GCA (0.58 \u00b1 0.04 (95%CI, 0.55\u20130.61)) and GCA + PMR (0.64 \u00b1 0.09 (95%CI, 0.57\u20130.71); p &lt; 0.0001, respectively). In individuals with a suspected diagnosis of rheumatic disease, an inflammatory-directed [18F]FDG PET\/CT can alter diagnosis in the majority of the cases, particularly in subjects who were referred because of diagnostic uncertainty. Semi-quantitative assessment may be helpful in establishing a final diagnosis of PMR, supporting the notion that a quantitative whole-body read-out may be useful in unclear cases.<\/jats:p>","DOI":"10.3390\/diagnostics11112073","type":"journal-article","created":{"date-parts":[[2021,11,9]],"date-time":"2021-11-09T21:39:07Z","timestamp":1636493947000},"page":"2073","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Whole-Body [18F]FDG PET\/CT Can Alter Diagnosis in Patients with Suspected Rheumatic Disease"],"prefix":"10.3390","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7745-3903","authenticated-orcid":false,"given":"Matthias","family":"Fr\u00f6hlich","sequence":"first","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sebastian","family":"Serfling","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9711-7835","authenticated-orcid":false,"given":"Takahiro","family":"Higuchi","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"},{"name":"Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama 700-8530, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6753-3010","authenticated-orcid":false,"given":"Martin G.","family":"Pomper","sequence":"additional","affiliation":[{"name":"The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2897-4694","authenticated-orcid":false,"given":"Steven P.","family":"Rowe","sequence":"additional","affiliation":[{"name":"The Russell H Morgan Department of Radiology and Radiological Science, Division of Nuclear Medicine, Baltimore, MD 21287, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marc","family":"Schmalzing","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Peter","family":"Tony","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gernert","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3168-7074","authenticated-orcid":false,"given":"Patrick-Pascal","family":"Strunz","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Portegys","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine II, Rheumatology\/Clinical Immunology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Eva-Christina","family":"Schwaneck","sequence":"additional","affiliation":[{"name":"Asklepios Klinik Altona, Rheumatology and Clinical Immunology, 22763 Hamburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ottar","family":"Gadeholt","sequence":"additional","affiliation":[{"name":"Rheumatologische Schwerpunkt Praxis W\u00fcrzburg, 97070 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4127-1347","authenticated-orcid":false,"given":"Alexander","family":"Weich","sequence":"additional","affiliation":[{"name":"Gastroenterology, Department of Internal Medicine II, University Hospital W\u00fcrzburg, 79080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas K.","family":"Buck","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thorsten A.","family":"Bley","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4840-0447","authenticated-orcid":false,"given":"Konstanze V.","family":"Guggenberger","sequence":"additional","affiliation":[{"name":"Department of Diagnostic and Interventional Radiology, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rudolf A.","family":"Werner","sequence":"additional","affiliation":[{"name":"Comprehensive Heart Failure Center, Department of Nuclear Medicine, University Hospital W\u00fcrzburg, 97080 W\u00fcrzburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1454","DOI":"10.1002\/art.24459","article-title":"Epidemiology of giant cell arteritis and polymyalgia rheumatica","volume":"61","author":"Martin","year":"2009","journal-title":"Arthritis Care Res."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1040","DOI":"10.1016\/j.semarthrit.2020.07.005","article-title":"Incidence and prevalence of giant cell arteritis and polymyalgia rheumatica: A systematic literature review","volume":"50","author":"Sharma","year":"2020","journal-title":"Semin. 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