18F-FDG PET/CT在IgG4相关性疾病中的应用

doi:DOI:10.12117/jccmi.2019.12.009

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (0 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To investigate the application of 18F-FDG PET/CT in IgG4-related diseases(IgG4-RD). Methods: This study retrospectively analyzed 47 cases of IgG4-RD diagnosed according to the comprehensive diagnostic criteria of IgG4-RD. The data of clinical information and 18F-FDG PET/CT presentation were collected and analyzed. Results: Of the 47 IgG4-RD patients, male was predominant(35/47, 74.47%) and the average age was 47.51 years(range 23~79 years). Forty-three cases displayed multiple organs involvement, and lymph nodes(29/47), pancreas(27/47) and salivary glands(16/47) were more common. All the involved lesions displayed high FDG uptake, and in which the salivary gland was the highest uptake(SUVmax 6.44±4.98), followed by lymph nodes and pancreas. 81.58% of the patients(31/38) involved the exocrine glands exhibiting symmetrical or diffuse gland swelling with increased homogeneous or heterogeneous metabolism. According to the grouping analysis of serum IgG4 elevation, the elevated IgG4 group was more prone to eosinophil elevation, prostate involvement, higher uptake of involved lacrimal gland and pancreas, and more sensitive to hormone therapy(All P<0.05). In the effective follow-up of 41 cases, 65.85% of patients were sensitive to hormone therapy. Although the serum IgG4 level was not significantly decreased after treatment, the 18F-FDG uptake of the involved lesions was significantly reduced. Conclusion: PET/CT is of great value in the diagnosis and differential diagnosis of IgG4-RD, the choice of biopsy site, the assessment of systemic organ involvement, and the monitoring of therapeutic effect.

Key words： Immunoglobulin G Fluorodeoxyglucose F18 Positron-emission tomography

Received: 09 October 2019

PACS:	Ｒ593.2
	Ｒ817.4

	Service

	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors

Cite this article:

URL:

http://www.jccmi.com.cn/EN/DOI:10.12117/jccmi.2019.12.009 OR http://www.jccmi.com.cn/EN/Y2019/V30/I12/875

[1]Li Y, Zhang J, Shen T, et al. IgG4-related diseases: A comprehensive review[J]. Xi Bao Yu Fen Zi Mian Yi Xue Za Zhi, 2019, 35(1): 83-88. [2]Okazaki K, UchidaK. Recent advances in IgG4-related disease, autoimmune pancreatitis and sclerosing cholangitis[J]. Nihon Rinsho, 2017, 75(3): 450-454. [3]Oprita R, Oprita B, Berceanu D, et al. Overview of IgG4-Related Disease[J]. J Med Life, 2017, 10(4): 203-207. [4]Wallace ZS, Perugino C, Matza M, et al. Immunoglobulin G4-related Disease[J]. Clin Chest Med, 2019, 40(3): 583-597. [5]Yadlapati S, Verheyen E, Efthimiou P. IgG4-related disease: a complex under-diagnosed clinical entity[J]. Rheumatol Int, 2018, 38(2): 169-177. [6]Kamisawa T, Okazaki K, Kawa S, et al. Japanese consensusguidelines for management of autoimmune pancreatitis: Ⅲ. Treatment and prognosis of AIP[J]. J Gastroenterol, 2010, 45(5): 471-477. [7]Umehara H, Okazaki K, Masaki Y, et al. Comprehensive diagnostic criteria for IgG4-related disease(IgG4-RD), 2011[J]. Mod Rheumatol, 2012, 22(1): 21-30. [8]Umehara H, Okazaki K, Nakamura T, et al. Current approach to the diagnosis of IgG4-related disease—Combination of comprehensive diagnostic and organ-specific criteria[J]. Mod Rheumatol, 2017, 27(3): 381-391. [9]Jadvar H, Colletti PM, Delgado-Bolton R, et al. Appropriate use criteria for 18F-FDG PET/CT in restaging and treatment response assessment of malignant disease[J]. J Nucl Med, 2017, 58(12): 2026-2037. [10]Meignan M, Itti E, Gallamini A, et al. FDG PET/CT imaging as a biomarker in lymphoma[J]. Eur J Nucl Med Mol Imaging, 2015, 42(4): 623-633. [11]Vadi SK, Parihar AS, Kumar R, et al. IgG4-Related Disease Simulating Carcinoma Colon With Diffuse Peritoneal Carcinomatosison 18F-FDG PET/CT[J]. Clin Nucl Med, 2018, 43(7): e247-e249. [12]Kashiwagi N, Enoki E, Hosokawa C, et al. 18F-FDG PET/CT Features of Chronic Sclerosing Sialadenitis Presenting as Localized IgG4-Related Disease[J]. Clin Nucl Med, 2017, 42(2): 131-132. [13]Kan Y, Yuan L, Wang W, et al. Unexpected Fibrosing Mediastinitis Shown on FDG PET/CT in a Patient With IgG4-Related Disease[J]. Clin Nucl Med, 2017, 42(10): 818-819. [14]Vadi SK, Kumar R, Mittal BR, et al. 18F-FDG PET/CT in an Atypical Case of Relapsed IgG4-Related Disease Presenting as Inflammatory Pseudotumor in Gall Bladder Fossa With Extensive Disease Involvement[J]. Clin Nucl Med, 2018, 43(10): e357-e359. [15]Pan Q, Wang Y, Luo Y, et al. Hepatic Involvement of IgG4-Related Disease Presenting as Multiple Hypermetabolic Masses on FDG PET/CT[J]. Clin Nucl Med, 2018, 43(10): 777-779. [16]Bélissant O, Guernou M, Rouvier P, et al. IgG4-Related Tubulointerstitial Nephritis Pattern in 18F-FDG PET/CT[J]. Clin Nucl Med, 2015, 40(10): 808-809. [17]Vankadari K, Mittal BR, Kumar R, et al. Isolated Involvement of Prostate Gland by Immunoglobulin G4-Related Disease Diagnosed With the Help of FDG PET/CT[J]. Clin Nucl Med, 2019, 44(9): e537-e539. [18]Parihar AS, Singh H, Kumar R, et al. Pancreatic Malignancy or Not?: Role of 18F-FDG PET/CT in Solving the Diagnostic Dilemma and Evaluating Treatment Response[J]. Clin Nucl Med, 2018, 43(4): e115-e117. [19]Zhang J, Chen H, Ma Y, et al. Characterizing IgG4-related disease with 18F-FDG PET/CT: a prospective cohort study[J]. Eur J Nucl Med Mol Imaging, 2014, 41(8): 1624-1634. [20]Ebbo M, Grados A, Guedj E, et al. Usefulness of 2-[18F]-fluoro-2-deoxy-D-glucose-positron emission tomography/computed tomography for staging and evaluation of treatment response in IgG4-related disease: a retrospective multicenter study[J]. Arthritis Care Res(Hoboken), 2014, 66(1): 86-96. [21]Ozaki Y, Oguchi K, Hamano H, et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography[J]. J Gastroenterol, 2008, 43(2): 144-151. [22]Zhao Z, Wang Y, Guan Z, et al. Utility of FDG-PET/CT in the diagnosis of IgG4-related diseases[J]. Clin Exp Rheumatol, 2016, 34(1): 119-125. [23]Ebbo M, Grados A, Bernit E, et al. Pathologies associated with serum IgG4 elevation[J]. Int J Rheumatol, 2012, 2012: 602809. [24]Yamamoto M, Tabeya T, Naishiro Y, et al. Value of serum IgG4 in the diagnosis of IgG4-related disease and in differentiation from rheumatic diseases and other diseases[J]. Mod Rheumatol, 2012, 22(3): 419-425. [25]Ozaki Y, Oguchi K, Hamano H, et al. Differentiation of autoimmune pancreatitis from suspected pancreatic cancer by fluorine-18 fluorodeoxyglucose positron emission tomography[J]. J Gastroenterol, 2008, 43(2): 144-151. [26]Wallace ZS, Deshpande V, Mattoo H, et al. IgG4-Related Disease: Clinical and Laboratory Features in One Hundred Twenty-Five Patients[J]. Arthritis Rheumatol, 2015, 67(9): 2466-2475.