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Evaluation of Spleen Glucose Metabolism Using 18F-FDG PET/CT in Patients with Febrile Autoimmune Disease

 Sung Soo Ahn  ;  Sang Hyun Hwang  ;  Seung Min Jung  ;  Sang-Won Lee  ;  Yong-Beom Park  ;  Mijin Yun  ;  Jason Jungsik Song 
 JOURNAL OF NUCLEAR MEDICINE, Vol.58(3) : 507-513, 2017 
Journal Title
Issue Date
Adolescent ; Adult ; Aged ; Autoimmune Diseases/complications ; Autoimmune Diseases/diagnostic imaging ; Autoimmune Diseases/metabolism* ; Female ; Fever of Unknown Origin/diagnostic imaging ; Fever of Unknown Origin/etiology ; Fever of Unknown Origin/metabolism* ; Fluorodeoxyglucose F18/pharmacokinetics ; Glucose/metabolism* ; Humans ; Male ; Metabolic Clearance Rate ; Middle Aged ; Molecular Imaging/methods* ; Organ Specificity Positron Emission Tomography Computed Tomography/methods* ; Reproducibility of Results ; Sensitivity and Specificity ; Spleen/diagnostic imaging ; Spleen/metabolism* ; Tissue Distribution ; Young Adult
18F-FDG PET/CT ; autoimmune disease ; bone marrow ; immunometabolism ; spleen
The purpose of this study was to evaluate the clinical significance of 18F-FDG uptake by the spleen in patients with autoimmune disease.

Methods: We retrospectively reviewed Severance Hospital's electronic medical records of patients hospitalized for the evaluation of fever who underwent 18F-FDG PET/CT. We found 91 patients with autoimmune diseases and 101 patients with localized infection. 18F-FDG uptake was assessed by measuring SUV in the spleen and liver. The spleen-to-liver ratio of the SUVmean (SLRmean) was calculated. Clinical and laboratory parameters were collected and evaluated for association with SLRmean In-hospital mortality was defined as all-cause mortality during hospital admission for fever.

Results: SLRmean was significantly higher in autoimmune disease than in localized infectious disease (1.28 ± 0.43 vs. 0.91 ± 0.21, P < 0.001). In autoimmune disease, SLRmean was correlated with monocytes, aspartate aminotransferase, alanine aminotransferase, albumin, and ferritin. Analysis of receiver-operating-characteristic curves revealed that in comparison with laboratory parameters, SLRmean had the highest performance in differentiating autoimmune from localized infectious disease. Multivariate logistic regression analysis demonstrated that high SLRmean and low platelets were significantly associated with in-hospital mortality in febrile autoimmune disease.

Conclusion: These findings suggest that spleen glucose metabolism is increased in febrile autoimmune disease. Spleen 18F-FDG uptake may provide information useful in differentiating febrile autoimmune disease from localized infectious disease and predicting clinical outcomes in febrile autoimmune disease.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Nuclear Medicine (핵의학교실) > 1. Journal Papers
Yonsei Authors
Park, Yong Beom(박용범)
Song, Jason Jungsik(송정식) ORCID logo https://orcid.org/0000-0003-0662-7704
Ahn, Sung Soo(안성수) ORCID logo https://orcid.org/0000-0002-9002-9880
Yun, Mijin(윤미진) ORCID logo https://orcid.org/0000-0002-1712-163X
Lee, Sang-Won(이상원) ORCID logo https://orcid.org/0000-0002-8038-3341
Jung, SeungMin(정승민) ORCID logo https://orcid.org/0000-0003-3465-2181
Hwang, Sang Hyun(황상현) ORCID logo https://orcid.org/0000-0002-8130-6671
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