Swart, G.M. (2019) Verschil tussen patiënten met en zonder calcinosis cutis in de mate van vasculopathie en orgaanbetrokkenheid en de toegevoegde waarde van 18F-NaF-PET-scan in het afbeelden van zowel weke delen als vasculaire calcificaties bij systemische sclerose. thesis, Medicine.
Full text available on request.Abstract
Difference between patients with and without calcinosis cutis in the degree of vasculopathy and organ involvement and the added value of 18F-NaF-PET-scan in imaging both soft tissue and vascular calcifications in systemic sclerosis Background: Systemic sclerosis (SSc) is a rare auto-immune disease characterized by fibrosis of the skin and internal organs as well as vascular damage. A common complication of SSc is calcification of the skin (calcinosis cutis) of whose genesis is not well known. The predisposition of the development of cutaneous and vascular calcifications may also be reflected in the development of vascular and organ damage in SSc-patients. Objective(s): to investigate the difference between SSc-patients with and without calcinosis cutis in the degree of vasculopathy or organ involvement (1) comparing cutaneous, subcutaneous and muscular calcifications on 18F-NaF-PET with the CT-scan (2) and to investigate the association between vascular calcifications (assessed on 18F-NaF-PET) and vascular and organ damage in SSc (3) Materials and method: This research was a cross-sectional, case-control pilot study at the UMCG. Groups with calcinosis cutis and without calcinosis cutis were compared. The differences between (micro)vasculopathy, organ involvement and inflammation in the blood were investigated. Nine SSc-patients underwent an 18F-NaF PET/CT-scan. Cutaneous, subcutaneous and muscular calcifications were described on CT-scan and 18F-NaF-PET. In the arteries, the target-to-background ratio (TBR) on 18F-NaF-PET and the calcified plaque (CP) score on CT-scan were calculated. Results: Fifteen SSc-patients with calcinosis cutis versus fourteen SSc-patients without calcinosis cutis were included in the study. Disease duration, age and the number of patients with telangiectasia were higher in patients with calcinosis cutis. No difference was shown between patients with calcinosis cutis and patients without calcinosis cutis with regard to the degree of (micro)vasculopathy and organ involvement. Almost all cutaneous, subcutaneous and muscular calcifications on 18F-NaF-PET were seen on CT-scan, only 7% were seen on 18F-NaF-PET. 52% of all cutaneous, subcutaneous and muscular calcifications on CT-scan were associated with 18F-NaF uptake. The more 18F-NaF uptake was seen on 18F-NaF-PET, the more vascular calcifications were seen on CT-scan. In addition, 18F-NaF uptake was seen where no evident vascular calcifications were seen on CT-scan. A trend was manifested between vascular calcifications (assessed on 18F-NaF-PET) and age, the late nailfoldcapillary pattern, digital ulcers, pitting scars, gastrointestinal involvement and CRP in SSc-patients with calcinosis cutis. Conclusion: No difference was demonstrated between SSc-patients with calcinosis cutis versus SSc-patients without calcinosis cutis in the degree of (micro)vasculopathy and the degree of organ involvement. In SSc-patients with calcinosis cutis, vascular and cutaneous, subcutaneous and muscular calcifications were imaged on 18F-NaF PET/CT-scan. In addition, early or active calcifications could potentially be imaged on the 18F-NaF-PET scan in both the soft tissue and the vessels in SSc. 18F-NaF uptake in the vessels appeared to be associated with age, (micro)vasculopathy, gastrointestinal involvement and inflammation in SSc-patients with calcinosis cutis.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Mulder, D.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 17 Sep 2020 07:29 |
| Last Modified: | 17 Sep 2020 07:29 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2762 |
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