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KMID : 0880420230240060590
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Korean Journal of Radiology
2023 Volume.24 No. 6 p.590 ~ p.598
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Pretherapy 18F-FDG PET/CT in Predicting Disease Relapse in Patients With Immunoglobulin G4-Related Disease: A Prospective Study
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Dingjie An
Yue Leon Guo
Ruoh-Fang Yen
Yen-Wen Wu
Hsiu-Po Wang
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Abstract
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Objective : To investigate whether the levels of inflammation detected by 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET)/computed tomography (CT) can predict disease relapse in immunoglobulin G4-related disease (IgG4-RD) patients receiving standard induction steroid therapy.
Materials and Methods : This prospective study analyzed pretherapy FDG PET/CT images from 48 patients (mean age, 63 ± 12.9 years; 45 males and 3 females) diagnosed with IgG4-RD between September 2008 and February 2018, who subsequently received standard induction steroid therapy as the first-line treatment. Multivariable Cox proportional hazards models were used to identify the potential prognostic factors associated with relapse-free survival (RFS).
Results : The median follow-up time for the entire cohort was 1913 days (interquartile range [IQR], 803?2929 days). Relapse occurred in 81.3% (39/48) patients during the follow-up period. The median time to relapse was 210 days (IQR, 140?308 days) after completion of standardized induction steroid therapy. Among the 17 parameters analyzed, Cox proportional hazard analysis identified whole-body total lesion glycolysis (WTLG) > 600 on FDG-PET as an independent risk factor for disease relapse (median RFS, 175 vs. 308 days; adjusted hazard ratio, 2.196 [95% confidence interval: 1.080?4.374]; P = 0.030).
Conclusion : WTLG on pretherapy FDG PET/CT was the only significant factor associated with RFS in IgG-RD patients receiving standard steroid induction therapy.
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KEYWORD
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18F-fluorodeoxyglucose, PET/CT, IgG4-RD, Relapse-free survival, Therapy
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