Correlation between disease activity and recurrence risk of adult-onset Still's disease and 18F-FDG PET/CT metabolic parameters

doi:10.11958/20252530

Abstract

Abstract:

Objective To investigate the correlation between the maximum standardized uptake value（SUV_max） of ¹⁸F-fluorodeoxyglucose（FDG）PET/CT and clinical disease activity score as well as recurrence risk of adult-onset Still's disease (AOSD). Methods A retrospective analysis was conducted on 17 patients with AOSD who underwent ¹⁸F-FDG PET/CT at Tianjin Union Medicine Center from June 2019 to December 2023. Spearman rank correlation analysis was performed to analyze the relationship between SUV_max of lymph nodes, spleen and bone marrow with clinical disease activity score and laboratory parameters, and those between lymph node SUV_max and maximum short-axis diameter. Patients were divided into the recurrent group and the non-recurrent group based on follow-up results. The differences in SUV_max, clinical disease activity score and clinical features were assessed between the two groups. Results All 17 patients showed ¹⁸F-FDG uptake in spleen, bone marrow and lymph nodes. Additionally, 2 patients (11.76%) showed increased ¹⁸F-FDG uptake in bilateral parotid glands (SUV_max 2.3, 4.3)，1 patient (5.88%) showed increased ¹⁸F-FDG uptake in bilateral elbows, wrists, hand joints, and left ankle（SUV_max 3.9), and 1 patient (5.88%) showed increased¹⁸F-FDG uptake in bilateral submandibular glands（SUV_max 3.4). The SUV_max of spleen and bone marrow were positively correlated with C-reactive protein levels（r_s value:0.575 and 0.549; both P<0.05), while the SUV_max of lymph nodes was positively associated with their maximum short-axis diameter（r_s value:0.522, P<0.05). There was no significant correlation between disease activity score and SUV_max in spleen, bone marrow, or lymph nodes (r_s value: -0.126, 0.100 and 0.007，P>0.05). The SUV_maxof spleen in the recurrence group (9 patients) was 5.20 (4.45, 6.05), which was significantly higher than that in the non-recurrence group [8 patients, 3.80 (2.70, 4.00), P<0.05]. Conclusion ¹⁸F-FDG PET/CT is a valuable tool for assessing AOSD disease activity and predicting disease recurrence, especially the SUV_max of spleen, which shows potential clinical value in predicting recurrence.

Key words: Still's disease, adult-onset, positron-emission tomography, tomography, X-ray computed, deoxyglucose, recurrence

CLC Number:

R593，R817.4

Figures/Tables 5

References 27

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指标	升高[例（%）]	降低[例（%）]
CRP	17（100.00）	0
ESR	17（100.00）	0
LDH	17（100.00）	0
中性粒细胞百分比	16（94.12）	0
ALT	7（41.18）	0
AST	6（35.29）	0
WBC	9（52.94）	0
Hb	0	12（70.59）
RBC	0	6（35.29）
PLT	0	1（5.88）
指标	范围（最小值~最大值）	测量值[$\bar{x} \pm s$/M（P₂₅，P₇₅）]
CRP	13.70~155.89 mg/L	39.00（20.16，63.60）mg/L
ESR	25.00~70.00 mm/1 h	（47.53±12.37） mm/1 h
LDH	276.00~702.00 U/L	（451.06±118.57） U/L
中性粒细胞百分比	68.70%~91.00%	82.44%±5.89%
ALT	10.00~346.80 U/L	32.30（22.50，127.15）U/L
AST	22.00~235.90 U/L	31.10（26.95，59.25）U/L
WBC	（5.14~21.45）×10⁹/L	（11.80±5.58）×10⁹/L
Hb	（65.00~138.00） g/L	（108.12±16.10） g/L
RBC	（2.55~4.53）×10¹²/L	（3.86±0.51）×10¹²/L
PLT	（100.00~339.00）×10⁹/L	（258.76±60.54）×10⁹/L

指标	升高[例（%）]	降低[例（%）]
CRP	17（100.00）	0
ESR	17（100.00）	0
LDH	17（100.00）	0
中性粒细胞百分比	16（94.12）	0
ALT	7（41.18）	0
AST	6（35.29）	0
WBC	9（52.94）	0
Hb	0	12（70.59）
RBC	0	6（35.29）
PLT	0	1（5.88）
指标	范围（最小值~最大值）	测量值[$\bar{x} \pm s$/M（P₂₅，P₇₅）]
CRP	13.70~155.89 mg/L	39.00（20.16，63.60）mg/L
ESR	25.00~70.00 mm/1 h	（47.53±12.37） mm/1 h
LDH	276.00~702.00 U/L	（451.06±118.57） U/L
中性粒细胞百分比	68.70%~91.00%	82.44%±5.89%
ALT	10.00~346.80 U/L	32.30（22.50，127.15）U/L
AST	22.00~235.90 U/L	31.10（26.95，59.25）U/L
WBC	（5.14~21.45）×10⁹/L	（11.80±5.58）×10⁹/L
Hb	（65.00~138.00） g/L	（108.12±16.10） g/L
RBC	（2.55~4.53）×10¹²/L	（3.86±0.51）×10¹²/L
PLT	（100.00~339.00）×10⁹/L	（258.76±60.54）×10⁹/L

¹⁸F-FDG摄取	系统性评分	CRP	LDH	ALT	AST	ESR	WBC	RBC	Hb	PLT	中性粒细胞百分比
脾脏SUV_max	-0.126	0.575^＊	0.430	-0.097	-0.381	0.058	-0.038	-0.232	-0.055	-0.377	-0.026
骨髓SUV_max	0.100	0.549^＊	0.390	0.034	0.052	-0.143	0.201	0.049	0.274	0.171	0.275
淋巴结SUV_max	0.007	0.350	0.123	0.208	0.002	-0.318	-0.157	0.226	0.234	0.230	-0.308

¹⁸F-FDG摄取	系统性评分	CRP	LDH	ALT	AST	ESR	WBC	RBC	Hb	PLT	中性粒细胞百分比
脾脏SUV_max	-0.126	0.575^＊	0.430	-0.097	-0.381	0.058	-0.038	-0.232	-0.055	-0.377	-0.026
骨髓SUV_max	0.100	0.549^＊	0.390	0.034	0.052	-0.143	0.201	0.049	0.274	0.171	0.275
淋巴结SUV_max	0.007	0.350	0.123	0.208	0.002	-0.318	-0.157	0.226	0.234	0.230	-0.308

组别	n		脾脏SUV_max			淋巴结SUV_max		年龄/岁		ALT/（U/L）		AST/（U/L）
非复发组	8		3.80（2.70，4.00）			6.55（3.15，11.75）		33.00（28.25，54.25）		33.37（24.05，216.65）		42.00（29.75，90.58）
复发组	9		5.20（4.45，6.05）			6.10（5.30，11.30）		31.00（25.00，55.00）		32.30（19.10，81.30）		29.70（23.70，41.00）
Z			3.486^＊			0.385		0.433		0.481		1.347
组别		系统性评分		骨髓SUV_max			RBC/（×10¹²/L）		CRP/（mg/L）		LDH/（U/L）
非复发组		4.63±1.19		5.05±1.26			4.00±0.46		30.70±17.36		415.63±114.20
复发组		4.44±1.13		5.64±1.30			3.74±0.55		64.72±42.19		482.56±119.74
t		0.321		0.954			1.057		2.121		1.175
组别		中性粒细胞百分比/%			ESR/（mm/1 h）		WBC/（×10⁹/L）		PLT/（×10⁹/L）		Hb/（g/L）
非复发组		82.60±4.38			43.88±13.44		12.30±5.81		282.00±52.37		113.50±14.52
复发组		82.29±7.25			50.78±11.09		11.37±5.68		238.11±62.54		103.33±16.70
t		0.105			1.160		0.334		1.557		1.331

Correlation between disease activity and recurrence risk of adult-onset Still's disease and ¹⁸F-FDG PET/CT metabolic parameters

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