Special Theme Article: Clinical Imaging and the Rheumatic Diseases
Present Role of Positron Emission Tomography in the Diagnosis and Monitoring of Peripheral Inflammatory Arthritis: A Systematic Review
Article first published online: 24 DEC 2013
Copyright © 2014 by the American College of Rheumatology
Arthritis Care & Research
Volume 66, Issue 1, pages 120–130, January 2014
How to Cite
Bruijnen, S. T. G., Gent, Y. Y. J., Voskuyl, A. E., Hoekstra, O. S. and van der Laken, C. J. (2014), Present Role of Positron Emission Tomography in the Diagnosis and Monitoring of Peripheral Inflammatory Arthritis: A Systematic Review. Arthritis Care Res, 66: 120–130. doi: 10.1002/acr.22184
- Issue published online: 24 DEC 2013
- Article first published online: 24 DEC 2013
- Accepted manuscript online: 7 OCT 2013 12:27PM EST
- Manuscript Accepted: 17 SEP 2013
- Manuscript Received: 27 MAR 2013
To determine the current status of positron emission tomography (PET) as a tool for diagnosis and monitoring of peripheral inflammatory arthritis (IA).
For conducting this systematic review, the PubMed (Medline), Embase, and Cochrane Library databases were searched until December 31, 2012. Studies of PET for diagnosis and/or therapy monitoring of peripheral IA were included. Data were summarized qualitatively using best evidence synthesis.
Eighteen articles met our inclusion criteria. The majority of studies were feasibility studies with varying methods applied. All studies demonstrated that PET visualized IA with high sensitivity, corresponding to clinical assessments. PET outcome of clinically active IA also matched that of ultrasound and magnetic resonance imaging. PET differentiates from other modalities by (quantitative) imaging of molecular sites in the synovium. The first studies reporting on the potential clinical applications of PET to image subclinical synovitis in preclinical RA and during therapy have been published. The results are promising, but the number and study populations of these studies are still limited.
Thus far, a limited number of PET studies addressing IA imaging have been published. The PET modality seems to offer highly sensitive and potentially specific imaging of IA at the (quantitative) molecular level. Clinical application studies for early diagnostics and therapy monitoring are arising, but these topics should be further explored in future studies with larger cohorts. For integration in clinical practice, aspects such as radiation burden and cost-effectiveness should also be taken into account.