Utility of fluorodeoxyglucose positron emission tomography/computed tomography for early diagnosis and evaluation of disease activity of relapsing polychondritis: a case series and literature review.
OBJECTIVE
Relapsing polychondritis (RPC) is relatively rare and early diagnosis is difficult. We investigated the utility of fluorodeoxyglucose (FDG)-PET/CT for the diagnosis of RPC and evaluation of disease activity.


METHODS
Five RPC patients undergoing FDG-PET/CT in our hospital between 2006 and 2012 were studied. Eight RPC cases examined by PET reported in the literature were also assessed. Data from a total of 13 patients were analysed.


RESULTS
Typical FDG accumulation was noted in the tracheobronchial trees of nine patients, the costal cartilage of five, joints of five, larynx of four, nasal cavity/paranasal sinuses of three, auricles of three, lymph nodes of three and the aorta of one. One patient showed nasal chondritis on a PET scan despite the absence of nasal changes on physical examination. Of five patients with costochondritis, four remained asymptomatic. Of nine patients with airway FDG accumulation, eight developed respiratory symptoms and all had CT abnormalities. In the other patient, airway FDG accumulation was evident despite the absence of airway symptoms and a lack of abnormalities in the respiratory function test and CT. PET also revealed bronchial chondritis in asymptomatic patients. The mean maximum standardized uptake values (SUVmax) of the upper and lower airways was 5.79 (s.d. 2.87) and 6.47 (s.d. 4.08), respectively. In five patients with a PET after treatment, FDG accumulation had diminished with symptomatic and inflammatory improvement.


CONCLUSION
FDG-PET/CT is a potentially powerful tool for the early diagnosis of RPC, especially in patients without easily biopsied organ involvement. This modality also facilitates evaluation of disease extent and disease activity during treatment.
['Yamashita|Hiroyuki|H|', 'Takahashi|Hiroyuki|H|', 'Kubota|Kazuo|K|', 'Ueda|Yo|Y|', 'Ozaki|Takashi|T|', 'Yorifuji|Hideki|H|', 'Bannai|Ei|E|', 'Minamimoto|Ryogo|R|', 'Morooka|Miyako|M|', 'Miyata|Yoko|Y|', 'Okasaki|Momoko|M|', 'Takahashi|Yuko|Y|', 'Kaneko|Hiroshi|H|', 'Kano|Toshikazu|T|', 'Mimori|Akio|A|']
D000368:Aged D042241:Early Diagnosis D005260:Female D019788:Fluorodeoxyglucose F18 D006801:Humans D008297:Male D008875:Middle Aged D064847:Multimodal Imaging D011081:Polychondritis, Relapsing D049268:Positron-Emission Tomography D014057:Tomography, X-Ray Computed
cartilage respiratory diagnostic imaging ears nose radionuclide imaging throat