Objective In routine care, clinicians may employ 2-[18F]fluoro-2-deoxy-D-glucose (FDG)-PET/CT to validate their initial clinical diagnosis of PMR. Nevertheless, the diagnostic utility of combining FDG-PET/CT findings with clinical presentation has not been explored. Therefore, this study aimed to investigate whether the diagnostic accuracy for PMR could be enhanced by combining FDG-PET/CT findings with the clinical baseline diagnosis or the 2012 ACR/EULAR clinical classification criteria for PMR. Methods An investigation and a validation cohort were included from two countries, encompassing 66/27 and 36/21 PMR/non-PMR patients, respectively. The cohorts comprised treatment-naïve patients suspected of PMR, who initially received a clinical baseline diagnosis and underwent FDG-PET/CT scans. The FDG-PET/CT Leuven score was applied to classify patients as either PMR or non-PMR and combined with the clinical baseline diagnosis. Final diagnoses were established through clinical follow-up after 12 or six months in the investigation and validation cohorts, respectively. Results In the investigation cohort, a clinical baseline diagnosis yielded a sensitivity/specificity of 94%/82%, compared with 78%/70% using the ACR/EULAR criteria. Combining the clinical baseline diagnosis with a positive Leuven score showed a sensitivity/specificity of 80%/93%, compared with 80%/82% for an ACR/EULAR-Leuven score. In the validation cohort, the baseline diagnosis revealed a sensitivity/specificity of 100%/91%, compared with 92%/76% using the ACR/EULAR criteria. Combining FDG-PET/CT with the baseline diagnosis demonstrated a sensitivity/specificity of 83%/95% compared with 89%/81% for the ACR/EULAR-Leuven score. Conclusion Combining FDG-PET/CT findings with the clinical baseline diagnosis or ACR/EULAR clinical classification criteria can improve the diagnostic specificity for PMR.

中文翻译：

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使用 FDG-PET/CT 结合临床诊断或 2012 ACR/EULAR 分类标准提高风湿性多肌痛的诊断准确性


目的 在常规护理中，临床医生可以采用 2-[18F]氟-2-脱氧-D-葡萄糖 (FDG)-PET/CT 来验证他们对 PMR 的初步临床诊断。然而，尚未探索将 FDG-PET/CT 结果与临床表现相结合的诊断效用。因此，本研究旨在探讨将FDG-PET/CT结果与临床基线诊断或2012年ACR/EULAR PMR临床分类标准相结合是否可以提高PMR的诊断准确性。方法 纳入来自两个国家的调查和验证队列，分别包含 66/27 和 36/21 PMR/非 PMR 患者。这些队列由疑似 PMR 的初治患者组成，他们最初接受了临床基线诊断并接受了 FDG-PET/CT 扫描。 FDG-PET/CT Leuven 评分用于将患者分类为 PMR 或非 PMR，并结合临床基线诊断。最终诊断是通过分别在调查组和验证组中 12 个月或 6 个月后的临床随访来确定的。结果 在研究队列中，临床基线诊断的敏感性/特异性为 94%/82%，而使用 ACR/EULAR 标准的敏感性/特异性为 78%/70%。将临床基线诊断与阳性 Leuven 评分相结合显示出敏感性/特异性为 80%/93%，而 ACR/EULAR-Leuven 评分的敏感性/特异性为 80%/82%。在验证队列中，基线诊断显示敏感性/特异性为 100%/91%，而使用 ACR/EULAR 标准为 92%/76%。将 FDG-PET/CT 与基线诊断相结合显示出敏感性/特异性为 83%/95%，而 ACR/EULAR-Leuven 评分的敏感性/特异性为 89%/81%。 结论 将FDG-PET/CT表现与临床基线诊断或ACR/EULAR临床分类标准相结合，可以提高PMR的诊断特异性。