Correlation between disease activity and recurrence risk of adult-onset Still's disease and 18 F-FDG PET/CT metabolic parameters

ZHANG Wenyan; LI Zugui; JIA Yongchun; JIANG Wei; ZHEN Yusheng; XU Liang

doi:10.11958/20252530

Abstract：Objective To investigate the correlation between the maximum standardized uptake value(SUVmax)of 18F-fluorodeoxyglucose(FDG)PET/CT and clinical disease activity score as well as recurrence risk of adult-onset Still´s disease(AOSD).Methods A retrospective analysis was conducted on 17 patients with AOSD who underwent 18F-FDG PET/CT at Tianjin Union Medicine Center from June 2019 to December 2023.Spearman rank correlation analysis was performed to analyze the relationship between SUVmax of lymph nodes,spleen and bone marrow with clinical disease activity score and laboratory parameters,and those between lymph node SUVmax and maximum short-axis diameter.Patients were divided into the recurrent group and the non-recurrent group based on follow-up results.The differences in SUVmax,clinical disease activity score and clinical features were assessed between the two groups.Results All 17 patients showed 18F-FDG uptake in spleen,bone marrow and lymph nodes.Additionally,2 patients(11.76%)showed increased 18F-FDG uptake in bilateral parotid glands(SUVmax 2.3,4.3),1 patient(5.88%)showed increased 18F-FDG uptake in bilateral elbows,wrists,hand joints,and left ankle(SUVmax 3.9),and 1 patient(5.88%)showed increased 18F-FDG uptake in bilateral submandibular glands(SUVmax 3.4).The SUVmax of spleen and bone marrow were positively correlated with C-reactive protein levels(rs value:0.575 and 0.549;both P＜0.05),while the SUVmax of lymph nodes was positively associated with their maximum short-axis diameter(rs value:0.522,P＜0.05).There was no significant correlation between disease activity score and SUVmax in spleen,bone marrow,or lymph nodes(rs value:-0.126,0.100 and 0.007,P＞0.05).The SUVmax of spleen in the recurrence group(9 patients)was 5.20(4.45,6.05),which was significantly higher than that in the non-recurrence group[8 patients,3.80(2.70,4.00),P＜0.05].Conclusion 18F-FDG PET/CT is a valuable tool for assessing AOSD disease activity and predicting disease recurrence,especially the SUVmax of spleen,which shows potential clinical value in predicting recurrence.