HOSHINO Junichi
   Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine
   Position   Professor and Division head
Article types Original article
Language English
Peer review Non peer reviewed
Title Diagnostic value of 18F-fluorodeoxyglucose positron emission tomography and computed tomography for differentiating polymyalgia rheumatica and rheumatoid arthritis: Using classification and regression tree analysis
Journal Formal name：Modern rheumatology
Abbreviation：Mod Rheumatol
ISSN code：14397609/14397595
Domestic / ForeginForegin
Volume, Issue, Page 34(3),pp.474-478
Author and coauthor Ikuma Daisuke, Sawa Naoki, Yamanouchi Masayuki, Oba Yuki, Mizuno Hiroki, Suwabe Tatsuya, Hoshino Junichi, Ubara Yoshifumi
Publication date 2024/03/28
Summary OBJECTIVES:Determining which sites were important to differentiate polymyalgia rheumatica (PMR) from rheumatoid arthritis (RA) using 18F-fluorodeoxyglucose (FDG) positron emission tomography and computed tomography (PET-CT) is challenging.METHODS:Patients with PMR or RA who were undergoing PET-CT were recruited at two mutual-aid hospitals in Japan between 2009 and 2018. Classification and regression tree (CART) analyses were performed to identify FDG uptake patterns that differentiated PMR from RA.RESULTS:We enrolled 35 patients with PMR and 46 patients with RA. Univariate CART analysis showed that FDG uptake in the shoulder joints, spinous processes of the lumbar vertebrae, pubic symphysis, sternoclavicular joints, ischial tuberosities, greater trochanters, and hip joints differentiated PMR from RA. Multivariate CART analysis revealed that FDG uptake by at least one of the ischial tuberosities had the highest diagnostic value for distinguishing PMR from RA (sensitivity, 77.1%; specificity, 82.6%). We performed the same CART analysis to patients who had not undergone treatment (PMR, n = 28; RA, n = 9). Similar results were obtained, and sensitivity and specificity were increased (sensitivity, 89.3%; specificity, 88.8%).CONCLUSIONS:In PET-CT, FDG uptake by at least one of the ischial tuberosities best discriminates between PMR and RA.
DOI 10.1093/mr/road051
PMID 37279960