Total Body PET/CT Scans Effective for Evaluating Arthritis, Study Shows

A new study shows that total body PET/CT scans are a successful tool for showing systemic joint involvement in patients with autoimmune arthritis. The results were published in The Journal of Nuclear Medicine.

The Centers for Disease Control and Prevention estimates that one in four adults, or 58 million Americans, have been diagnosed with autoimmune inflammatory arthritides (AIA) – such as psoriatic arthritis and rheumatoid arthritis. By 2040, it’s projected that 78 million million adults will be diagnosed with arthritis. Such numbers make it difficult to manage this growing population.

“Currently, there are significant clinical challenges in managing AIA populations. For example, it is unclear which patients should receive which treatments, how exactly these treatments change the inflammatory status of different tissues or outcomes, and the impact the disease and treatments have on other organs of the body,” said Abhijit J. Chaudhari, PhD, professor of radiology at the University of California–Davis in Davis, California via a press release. “Systemic molecular imaging enabled by total body PET could provide currently unavailable, objective biomarkers that could help address these challenges.”

The researchers analyzed molecular imaging for evaluating AIA by using an ultra-low dose ¹⁸F-FDG total-body PET/CT acquisition protocol to scan 30 participants (24 with AIA and six with osteoarthritis). The population of interest also underwent a joint-by-joint rheumatological evaluation. The study total population comprised of 1,997 joints.

Encouragingly, the study demonstrated total body PET/CT was successful in visualizing ¹⁸F-FDG uptake at joints throughout the entire body, including those of the hands and feet, without the need for altered patient positioning. In the AIA group, the researchers observed that in the AIA cohort, researchers observed a positive link between total body PET qualitative assessments and joint-by-joint rheumatological evaluation for almost 70% percent of the participants. Notably, in the osteoarthritis cohort, there was agreement in joint assessment in over 91% percent of participants.

“Systemic evaluation of arthritic disease activity across all musculoskeletal tissues of the body may provide unique insights for assessing disease burdenrisk stratification, treatment selection, and monitoring on treatment response. The biomarkers imaged may also have clear potential to accelerate arthritic drug discovery and development,” said Dr. Chaudhari. “In addition, the inflammatory arthritides assessed in the paper are part of a broad category of autoimmune disorders. This work may contribute to improved understanding of total-body impact of autoimmunity.”