Defining the clinical utility of PET or PET-CT in idiopathic inflammatory myopathies: A systematic literature review
Journal Title
Seminars in Arthritis and Rheumatism
Abstract
Objectives Positron emission tomography (PET), often combined with computed tomography (CT), is a well-established tool for diagnosing malignancy and inflammatory disease. The idiopathic inflammatory myopathies (IIM) are chronic, multi-system diseases characterised by skeletal muscle inflammation, the potential for extramuscular manifestations such as interstitial lung disease (ILD) and an increased risk of malignancy. We performed a systematic literature review to evaluate the utility of PET or PET-CT in evaluation of IIM. Methods A search of Medline and EMBASE from 1990 to 2022 using keywords related to IIM and PET was performed. English language studies of adults with IIM who had PET or PET-CT were included. Results Our search identified 1173 potentially relevant abstracts, 19 of which were included. The majority of studies used [18F] fluorodeoxyglucose (FDG) PET or PET-CT scans, while the remainder used [18F] florbetapir and [11C] Pittsburgh compound B ([11C] PIB). The sensitivity and specificity of 18F-FDG-PET or 18F-FDG-PET-CT for diagnosing malignancy compared with standard detection methods was 66.7–94% and 80–97.8%, respectively. The sensitivity of 18F-FDG PET-CT for ILD was 93–100% when high-resolution CT was used as the reference standard. 18F-PET and 18F-FDG-PET-CT appear to accurately detect muscle inflammation, although correlations with clinical measures of IIM disease activity were variable. [18F] florbetapir PET-CT and [11C] PIB PET were able to differentiate sporadic inclusion body myositis (IBM) from non-IBM IIM. Conclusion PET-CT holds promise as a single tool that can simultaneously evaluate multiple aspects of IIM. These include screening for associated malignancy, achieving an early diagnosis of ILD and evaluating muscle inflammation.
Publisher
Elsevier
Keywords
Myositis; PET; PET-CT; Malignancy screening; Interstitial lung disease; Inflammatory myopathies
Research Division(s)
Inflammation
PubMed ID
36335683
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Creation Date: 2022-11-08 02:27:09
Last Modified: 2022-12-05 07:34:30
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