Use of FDG-PET Scan for the Assessment of Large Vessel Vasculitis

Temporal artery biopsy will only detect (part of) the cranial forms of giant cell arteritis. For the large vessel variant of this type of vasculitis, FDG-PET is the technique of choice. Since treatment of large vessel vasculitis implies long-term treatment with steroids, it is important to have a firm diagnosis. I suggest performing a FDG-PET scan in every patient in whom large vessel vasculitis is suspected and in whom the temporal artery biopsy is negative. In the follow-up of giant cell arteritis patients, we can rely on clinical symptoms and inflammatory parameters to monitor disease activity and to adapt our treatment and do not need to repeat FDG-PET scan. In Takayasu arteritis, follow-up FDG-PET scans are probably necessary to assess ongoing inflammation, but prospective studies are lacking.