SAT0557 RESIDUAL DISEASE ACTIVITY IN ADULT-ONSET STILL’S DISEASE: QUALITATIVE AND QUANTITATIVE ANALYSIS OF A SERIES OF 18F FDG-PET/MR

Background: Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disorder characterized by episodes of spiking fever, the presence of an evanescent pink-salmon rash, arthritis/arthralgias, sore throat and increased inflammatory serum markers. The diagnosis is clinical and needs the excl...

Full description

Bibliographic Details
Published in:Annals of the Rheumatic Diseases
Main Authors: Bindoli, S., Galozzi, P., Magnani, F., Abruzzino, G., Cecchin, D., Sfriso, P.
Format: Article in Journal/Newspaper
Language:English
Published: BMJ 2020
Subjects:
Online Access:http://dx.doi.org/10.1136/annrheumdis-2020-eular.5747
https://syndication.highwire.org/content/doi/10.1136/annrheumdis-2020-eular.5747
Description
Summary:Background: Adult-onset Still’s disease (AOSD) is a systemic autoinflammatory disorder characterized by episodes of spiking fever, the presence of an evanescent pink-salmon rash, arthritis/arthralgias, sore throat and increased inflammatory serum markers. The diagnosis is clinical and needs the exclusion of potential mimickers such as infections and lymphoproliferative disorders. Currently, a specific diagnostic test to assess the disease activity is not available. Objectives: To define the residual disease activity in AOSD and establish a possible response to therapy through 18 F-FDG PET/MR imaging technique. Methods: 23 patients affected by AOSD and 24 controls underwent 18 F-FDG PET/MR between 2014 and 2018. A total of 54 18 F-FDG PET/MR were analysed. AOSD patients were diagnosed according to the Yamaguchi’s criteria and were in follow-up at the Rheumatology Unit of Padova University Hospital. The controls were chosen among non-AOSD patients with a previous diagnosis of solid tumors (lymphomas excluded). A qualitative analysis of PET/RM carried out by a Nuclear Medicine Specialist and a semiquantitative analysis carried out by measuring SUVs-to-liver (Standardized Uptake Value) for spleen, bone marrow (BM), lymph nodes and pharynx were performed. A SUVmax BM/SUVmean liver higher than 2.09 was set up as significant area of uptake for each organ considered. This threshold was calculated by adding the standard deviation multiplied by 2 at the mean ratio between SUVmax BM and SUVmean liver of the control group. The Pouchot score for disease activity was calculated for each subject. The distribution of the variables was investigated by Shapiro-Wilk test. The analysis of the association between the variables was carried out using the Mann-Whitney U test. Results: AOSD patients present areas of focal 18 F-FDG uptake mainly in BM, lymph nodes, pharynx, spleen and salivary glands. Sites of uptake in spleen were found in 3.3% of PET/MR, in BM in 23.3%, in lymph nodes in 23.3% and in pharynx in 36.6% of PET/RM ...