Diagnostic Accuracy of FDG PET/CT of Cranial Arteries in GCA

NCT ID: NCT03409913

Last Updated: 2018-01-24

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Total Enrollment

106 participants

Study Classification

OBSERVATIONAL

Study Start Date

2014-10-01

Study Completion Date

2017-12-31

Brief Summary

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A case-control study to evaluate the diagnostic accuracy of FDG uptake in cranial arteries by FDG PET/CT in the diagnosis of giant cell arteritis.

Detailed Description

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Although older studies argue that FDG PET/CT cannot demonstrate inflammation in cranial arteries, e.g. temporal and maxillary arteries, the resolution of modern PET systems may have improved, making a case for FDG PET/CT. FDG PET/CT is increasingly used in giant cell arteritis (GCA) diagnosis due to its excellent diagnostic accuracy considering large-vessel involvement. In case of uncommon distribution of vessel involvement or marginally increased large-vessel FDG uptake, FDG PET/CT-specificity may be compromised. Hence, recognising FDG uptake in cranial arteries potentially adds to FDG PET/CTs diagnostic accuracy.

Objectives To evaluate the diagnostic accuracy of conventional FDG PET/CT of the cranial arteries in the diagnosis of GCA.

Methods In a cohort of consecutively included glucocorticoid-naïve patients suspected of new-onset GCA, patients with a clinical GCA diagnosis will be identified. Conventional FDG PET/CT and vascular ultrasound(US) was performed before treatment. Patients were referred for a temporal artery biopsy (TAB).

Controls are age-(+/- 3 years) and sex-matched malignant melanoma (MM) patients who had a follow-up metastatic-disease-free FDG PET/CT ≥6 months after MM resection.

Images will be assessed by 5 nuclear medicine physicians blinded to clinical symptoms and findings. Temporal (TA), maxillary (MA) and vertebral (VA) arteries will be visually assessed. Arterial FDG uptake more than FDG uptake in surrounding tissue is considered positive. Sensitivity, specificity and interreader agreement will be evaluated.

Conditions

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Giant Cell Arteritis

Study Design

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Observational Model Type

CASE_CONTROL

Study Time Perspective

RETROSPECTIVE

Study Groups

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GCA cases

In a cohort of patients suspected of GCA based on the following inclusion criteria were 1) age ≥50 years, 2) CRP\>15mg/l or ESR\>40mm/h, 3) either a) cranial symptoms, b) new-onset extremity claudication or c) weight loss \>5 kilograms or fever\>38oC for \>3 weeks, patients with a clinical diagnosis of GCA is identified.

FDG PET/CT

Intervention Type RADIATION

Conventional FDG PET/CT including head in order to asses cranial arteries.

controls

Age-(+/- 3 years) and sex-matched malignant melanoma (MM) patients who had a follow-up metastatic-disease-free FDG PET/CT ≥6 months after MM resection

FDG PET/CT

Intervention Type RADIATION

Conventional FDG PET/CT including head in order to asses cranial arteries.

Interventions

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FDG PET/CT

Conventional FDG PET/CT including head in order to asses cranial arteries.

Intervention Type RADIATION

Other Intervention Names

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Temporal artery biopsy Vascular ultrasound Inflammatory biomarkers

Eligibility Criteria

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Inclusion Criteria

Cases:

* 1\) age ≥50 years, 2) CRP\>15mg/l or ESR\>40mm/h, 3) either a) cranial symptoms, b) new-onset extremity claudication or c) weight loss \>5 kilograms or fever\>38oC for \>3 weeks and a clinical diagnosis of giant cell arteritis judged by expert rheumatologist.

Controls:

* age-(+/-3 years) and sex-matched malignant melanoma (MM) patients
* follow-up metastatic-disease-free FDG PET/CT ≥6 months after MM resection

Exclusion Criteria

* Previous diagnosis of polymyalgia or giant cell arteritis
* immunosuppresive treatment within last month
Minimum Eligible Age

50 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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University of Aarhus

OTHER

Sponsor Role lead

Responsible Party

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Responsibility Role SPONSOR

Principal Investigators

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Lars Christian Gormsen, MD, PhD

Role: STUDY_CHAIR

Department of Nuclear Medicine and PET centre, Aarhus University Hospital

Locations

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Department of Rheumatology

Aarhus, , Denmark

Site Status

Countries

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Denmark

Other Identifiers

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Cranial_GCA_PET

Identifier Type: -

Identifier Source: org_study_id

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