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. 2022 Dec;29(6):2920-2933.
doi: 10.1007/s12350-021-02812-6. Epub 2021 Oct 26.

Vascular/perivascular inflammation in IgG4-related disease

Shinichi Imai  1 , Nobuhiro Tahara  2 , Sachiyo Igata  3 , Atsuko Tahara  3 , Munehisa Bekki  3 , Yoichi Sugiyama  3 , Shoko Maeda-Ogata  3 , Akihiro Honda  3 , Hiroyuki Otsuka  1 , Tomoyuki Ushijima  4 , Yoshinobu Okabe  4 , Hayato Kaida  5 , Toshi Abe  6 , Hiroyuki Tanaka  1 , Yoshihiro Fukumoto  3 , Eiki Tayama  1
Affiliations

Vascular/perivascular inflammation in IgG4-related disease

Shinichi Imai et al. J Nucl Cardiol. 2022 Dec.

Abstract

Background: Immunoglobulin G4-related disease (IgG4-RD) is characterized by the infiltration of IgG4-positive plasma cells and fibrosclerotic inflammation in multiple organs. Although vascular complications are present in some patients with IgG4-RD, vascular and/or perivascular inflammatory activity compared to control subjects remains unknown. This study sought to investigate vascular/perivascular inflammation in IgG4-RD patients compared to control subjects using 18F-fluorodeoxyglucose-positron emission tomography combined with computed tomography (FDG-PET/CT).

Methods: We examined 37 consecutive patients diagnosed as IgG4-RD (29 males, mean age of 64.3 ± 8.3 years old), who underwent FDG-PET/CT. Thirty-seven age- and gender-matched subjects without IgG4-RD were employed as controls. Vascular/perivascular inflammation was quantified by blood-normalized standardized uptake value, known as a target-to-background ratio (TBR).

Results: All IgG4-RD patients presented with multiple region involvements. Twelve (32.4%) of the IgG4-RD patients had vascular complications, all of which appeared in the abdominal aorta. IgG4-RD patients had significantly higher TBR values in the descending aorta, abdominal aorta, and common iliac artery than control subjects. Also, IgG4-RD patients with vascular complication exhibited higher TBR values in the infra-renal aorta and common iliac artery than those without vascular complication.

Conclusions: We found that vascular FDG activity is significantly elevated in IgG4-RD patients regardless of vascular complication than control subjects. FDG-PET/CT is a useful modality for assessing vascular/perivascular inflammation, which may contribute vascular complication in IgG4-RD patients.

Keywords: Cardiovascular complication; FDG-PET/CT; IgG4-related disease; Vascular/perivascular inflammation.

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