Large vessel vasculitis (LVV) is defined as a disease affecting mainly large arteries, with two major variants, Takayasu arteritis (TA) and giant cell arteritis (GCA). GCA often coexists together with PMR in the same patient, since both belong to the same disease spectrum. FDGPET/CT is a functional imaging technique, which is an established tool in oncology, and has also demonstrated to have a role in the field of inflammatory diseases. Functional FDG-PET combined with anatomical CT angiography, FDG-PET/CT(A), may be of synergistic value for optimal diagnosis, disease activity monitoring, and evaluation of damage development of LVV. There are currently no guidelines regarding PET imaging acquisition for LVV and PMR, even though standardization is of utmost importance to facilitate clinical studies and for daily clinical practice.
This is a joint procedural recommendation on FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica from the Cardiovascular and Inflammation & Infection Committees of the European Association of Nuclear Medicine (EANM), the Cardiovascular Council of the Society of Nuclear Medicine and Molecular Imaging (SNMMI), the PET Interest Group (PIG), and endorsed by the American Society of Nuclear Cardiology (ASNC) The aim of this joint paper is to provide recommendations and statements, based on the available evidence in the literature and consensus of experts in the field, for patient preparation, FDG-PET/CT(A) acquisition and interpretation for the diagnosis and follow up of patients with suspected or diagnosed LVV and/or PMR. This position paper aims to set an internationally accepted standard for FDG-PET/CT(A) imaging and reporting of LVV and PMR.