Scientific Abstracts Thursday, 14 June 2018 413 on 12 June 2018 by ...
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Scientific Abstracts Thursday, 14 June 2018 413 on 12 June 2018 by ...
COMBINED POSITRON EMISSION TOMOGRAPHY AND MAGNETIC RESONANCE IMAGING FOR THE ASSESSMENT OF SYSTEMIC SCLEROSIS GASTROINTESTINAL INVOLVEMENT
1,2 S.-A. Ng , S. Marchesseau3, Y. Wang4, J. Schaefferkoetter3, W. Xie5, D. Ng5, J. Totman3, A.H. Low1,2. 1Rheumatology and Immunology, Singapore General Hospital; 2Duke-National University of Singapore; 3Clinical Imaging Research Center, A*STAR and National University of Singapore; 4Gastroenterology and Hepatology; 5Nuclear Medicine and PET, Singapore General Hospital, Singapore, Singapore
Background: The gastrointestinal (GI) tract is affected in 90% of patients with systemic sclerosis (SSc), a disease characterised by excessive fibrosis. Baseline GI involvement is an independent predictor of 2 year mortality in patients with early diffuse cutaneous SSc. There is an urgent need to develop non-invasive methods of assessing SSc GI involvement for early diagnosis and monitoring. Novel non-invasive tools such as fluorodeoxyglucose-positron emission tomography (FDG-PET) and magnetic resonance imaging (MRI) have been used in oncology. Development of a new MRI sequence, T1 MOLLI (modified look-locker inversion recovery) mapping, has been used in cardiac imaging for detection and quantification of diffuse fibrosis. Objectives: In this pilot study comparing SSc patients with healthy controls, we investigated whether FDG-PET-MRI is able to detect fibrosis and inflammation associated with SSc GI tract involvement. Methods: We recruited 16 patients fulfilling the 2013 ACR/EULAR criteria for SSc and 15 healthy age-matched (within 5 years) controls. Severity of GI involvement was determined by the total Gastrointestinal Tract score (GIT, from University of California Los Angeles Scleroderma Clinical Trials Consortium). All subjects fasted 6 hours prior and had non-spicy low-residue diet 3 days prior. Subjects were injected with FDG (6mCi) 1 hour prior and 10 mg hyoscine butylbromide (to reduce peristalsis) immediately before scanning. Breath-hold native T1 MOLLI mapping was acquired. FDG uptake was quantified by specific uptake value (SUV). All SSc patients and 5 controls underwent PET-MRI protocol. The remaining 10 controls only had MRI scanning. Student t-test was performed and statistical significance was taken to be p
