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Use of FDG PET scans enables comprehensive skeletal muscle evaluation
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The use of fluorodeoxyglucose positron emission tomography allowed researchers to successfully identify clinical signs of inflammation in patients with polymyositis and dermatomyositis, according to recently published data.
Thirty-three patients with newly onset polymyositis and dermatomyositis (PM/DM) were identified through medical records from the Department of Neurology at Iwate National Hospital in Japan. Patients showed symmetrical proximal muscle weakness, elevated serum muscle enzymes and myositis-compatible electrophysiological findings, and all underwent fluorodeoxyglucose positron emission tomography (FDG PET) scans either before or shortly after beginning glucocorticoid therapy between January 2009 and July 2013.
Researchers retrospectively reviewed clinical records and laboratory data for the patients with PM/DM, as well as for 22 patients with amyotrophic lateral sclerosis (ALS) with similar disabilities who were selected as controls. The researchers also compared MRI and FDG PET findings for 24 patients with PM/DM.
Of the 33 patients with PM/DM, eight underwent FDG PET and 25 underwent FDG PET/CT evaluation. FDG PET was performed before any treatment with glucocorticoids in 25 patients. In the remaining eight, FDG PET was performed shortly after the initiation of glucocorticoid therapy.
Abnormal FDG uptake was seen in the lungs in several patients, most of whom were diagnosed with interstitial lung disease, according to the researchers. In 50% of patients with DM, FDG uptake was seen in the lymph nodes, in 18.2% of PM patients without other collagen diseases and in 75% of patients with PM/DM and other collagen diseases.
Correlations with the maximum, standardized uptake value (SUV) and necrosis or regeneration scores, and patients with PM/DM had a higher maximum SUV than patients with ALS.
The researchers concluded that FDG PET is useful in identifying clinical characteristics of inflammation in PM/DM, and that an advantage to its use is its ability to be performed on the whole body in one scan. – by Shirley Pulawski
Disclosure: The authors have no relevant financial disclosures.
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