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Research ArticleArticle

Articular 18Fluorodeoxyglucose Uptake Is Associated With Clinically Assessed Swollen Joint Count in Patients With Rheumatoid Arthritis

Ivan Ferraz-Amaro, Arif Sheikh, Berna Polack, Jon T. Giles and Joan M. Bathon
The Journal of Rheumatology August 2022, jrheum.220231; DOI: https://doi.org/10.3899/jrheum.220231
Ivan Ferraz-Amaro
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number AR-050026 [JMB]), and by the National Institutes of Health (NIH) National Center for Translational Science Clinical and Translational Science Award (CTSA grant UL1 TR000040), and by the Rheumatology Research Foundation (award number RHEUMARF CU12-3892). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. I. Ferraz-Amaro, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; A. Sheikh, MD, Department of Radiology, Division of Nuclear Medicine, Kettering Health, Dayton, Ohio, USA; B. Polack, MD, Visiting Professor, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, New York, USA; J.T. Giles, MD, J.M. Bathon, MD, Division of Rheumatology, Department of Medicine, Columbia University College of Physicans and Surgeons, New York, New York, USA. BP is currently Head of Medical Information, Global Medical Affairs, Advanced Accelerator Applications, a Novartis Company. Her contribution to this work was performed while a Visiting Professor in Radiology at Columbia University. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Ferraz-Amaro. Division of Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. Email: iferrazamaro@hotmail.com. Accepted for publication July 22, 2022.
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Arif Sheikh
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number AR-050026 [JMB]), and by the National Institutes of Health (NIH) National Center for Translational Science Clinical and Translational Science Award (CTSA grant UL1 TR000040), and by the Rheumatology Research Foundation (award number RHEUMARF CU12-3892). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. I. Ferraz-Amaro, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; A. Sheikh, MD, Department of Radiology, Division of Nuclear Medicine, Kettering Health, Dayton, Ohio, USA; B. Polack, MD, Visiting Professor, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, New York, USA; J.T. Giles, MD, J.M. Bathon, MD, Division of Rheumatology, Department of Medicine, Columbia University College of Physicans and Surgeons, New York, New York, USA. BP is currently Head of Medical Information, Global Medical Affairs, Advanced Accelerator Applications, a Novartis Company. Her contribution to this work was performed while a Visiting Professor in Radiology at Columbia University. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Ferraz-Amaro. Division of Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. Email: iferrazamaro@hotmail.com. Accepted for publication July 22, 2022.
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Berna Polack
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number AR-050026 [JMB]), and by the National Institutes of Health (NIH) National Center for Translational Science Clinical and Translational Science Award (CTSA grant UL1 TR000040), and by the Rheumatology Research Foundation (award number RHEUMARF CU12-3892). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. I. Ferraz-Amaro, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; A. Sheikh, MD, Department of Radiology, Division of Nuclear Medicine, Kettering Health, Dayton, Ohio, USA; B. Polack, MD, Visiting Professor, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, New York, USA; J.T. Giles, MD, J.M. Bathon, MD, Division of Rheumatology, Department of Medicine, Columbia University College of Physicans and Surgeons, New York, New York, USA. BP is currently Head of Medical Information, Global Medical Affairs, Advanced Accelerator Applications, a Novartis Company. Her contribution to this work was performed while a Visiting Professor in Radiology at Columbia University. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Ferraz-Amaro. Division of Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. Email: iferrazamaro@hotmail.com. Accepted for publication July 22, 2022.
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Jon T. Giles
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number AR-050026 [JMB]), and by the National Institutes of Health (NIH) National Center for Translational Science Clinical and Translational Science Award (CTSA grant UL1 TR000040), and by the Rheumatology Research Foundation (award number RHEUMARF CU12-3892). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. I. Ferraz-Amaro, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; A. Sheikh, MD, Department of Radiology, Division of Nuclear Medicine, Kettering Health, Dayton, Ohio, USA; B. Polack, MD, Visiting Professor, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, New York, USA; J.T. Giles, MD, J.M. Bathon, MD, Division of Rheumatology, Department of Medicine, Columbia University College of Physicans and Surgeons, New York, New York, USA. BP is currently Head of Medical Information, Global Medical Affairs, Advanced Accelerator Applications, a Novartis Company. Her contribution to this work was performed while a Visiting Professor in Radiology at Columbia University. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Ferraz-Amaro. Division of Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. Email: iferrazamaro@hotmail.com. Accepted for publication July 22, 2022.
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Joan M. Bathon
Research reported in this publication was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases (award number AR-050026 [JMB]), and by the National Institutes of Health (NIH) National Center for Translational Science Clinical and Translational Science Award (CTSA grant UL1 TR000040), and by the Rheumatology Research Foundation (award number RHEUMARF CU12-3892). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH. I. Ferraz-Amaro, MD, Division of Rheumatology, Hospital Universitario de Canarias, Tenerife, Spain; A. Sheikh, MD, Department of Radiology, Division of Nuclear Medicine, Kettering Health, Dayton, Ohio, USA; B. Polack, MD, Visiting Professor, Department of Radiology, Columbia University College of Physicians and Surgeons, New York, New York, USA; J.T. Giles, MD, J.M. Bathon, MD, Division of Rheumatology, Department of Medicine, Columbia University College of Physicans and Surgeons, New York, New York, USA. BP is currently Head of Medical Information, Global Medical Affairs, Advanced Accelerator Applications, a Novartis Company. Her contribution to this work was performed while a Visiting Professor in Radiology at Columbia University. The remaining authors declare no conflicts of interest relevant to this article. Address correspondence to Dr. I. Ferraz-Amaro. Division of Rheumatology, Hospital Universitario de Canarias, 38320 Santa Cruz de Tenerife, Spain. Email: iferrazamaro@hotmail.com. Accepted for publication July 22, 2022.
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Abstract

Objective Examination and conventional radiography of joints are unable to precisely evaluate and measure disease activity in rheumatoid arthritis (RA). We quantified joint inflammation using 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) in people with RA to determine if PET-derived uptake variables were correlated with RA disease activity measures.

Methods We cross-sectionally studied 34 patients with RA in a substudy of the Rheumatoid Arthritis Study of the Myocardium (RHYTHM). All patients underwent 18F-FDG-PET scanning with CT for attenuation correction and anatomic co-registration. Linear regression was used to model the associations of disease activity scores with articular FDG uptake, calculated as standardized uptake values (SUVs). Weighted joint volume SUVs (wjSUV) representing 25%, 50%, 75%, and maximum (100%) uptake (wj25SUV, wj50SUV, wj75SUV, and wjMaxSUV, respectively) were calculated as global variables of the total volume of joint inflammation in each patient.

Results Calculated wj25SUV (Spearman ρ = 0.39, P = 0.04), wj50SUV (ρ = 0.39, P = 0.04), and wj75SUV (ρ = 0.37, P = 0.045) measures were significantly correlated with the number of swollen joints. Similar significant correlations were found for the Simplified Disease Activity Index but not Clinical Disease Activity or Disease Activity Score in 28 joints. No associations were found between articular FDG uptake and nonarticular RA-related variables (ie, disease duration, seropositivity, or RA treatments).

Conclusion Articular FDG uptake in patients with RA was significantly correlated with the number of swollen joints but not with biochemical measures of inflammation.

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The Journal of Rheumatology
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1 Jan 2023
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Articular 18Fluorodeoxyglucose Uptake Is Associated With Clinically Assessed Swollen Joint Count in Patients With Rheumatoid Arthritis
Ivan Ferraz-Amaro, Arif Sheikh, Berna Polack, Jon T. Giles, Joan M. Bathon
The Journal of Rheumatology Aug 2022, jrheum.220231; DOI: 10.3899/jrheum.220231

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Articular 18Fluorodeoxyglucose Uptake Is Associated With Clinically Assessed Swollen Joint Count in Patients With Rheumatoid Arthritis
Ivan Ferraz-Amaro, Arif Sheikh, Berna Polack, Jon T. Giles, Joan M. Bathon
The Journal of Rheumatology Aug 2022, jrheum.220231; DOI: 10.3899/jrheum.220231
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