Use of Pet/CT in different scenarios on rare and orphan diseases of autoimmune origin

Main Article Content

Liset Sánchez Ordúz http://orcid.org/0000-0001-9794-9017 Marylin Acuña Hernandez http://orcid.org/0000-0001-7381-1910 Gerardo H. Cortés Germán

Abstract

Autoimmune diseases are on the rise, likely due to many factors such as pollution, infections, dietary changes, climate modifications, and exposure to xenobiotics. These diseases impact individuals, society, and healthcare systems. Some diseases are well-known, such as type 1 diabetes, while others are orphan or rare diseases.


According to the WHO, rare diseases affect fewer than five people, 10,000 inhabitants, and over 7,000 diseases. These conditions generally have low prevalence, are mostly chronically debilitating, and typically lack treatment.


In 2013, the European Society of Nuclear Medicine and the Society of Nuclear Medicine and Molecular Imaging published guidelines for using [18F]FDG (the main radiotracer) in PET/CT studies of inflammation and infection. The use of this radiotracer has expanded in recent decades.


Our objective was to describe the use of PET/CT and its various radiotracers in rare or orphan autoimmune diseases classified in ICD-11. To achieve this, we followed the methodology outlined by the Joanna Briggs Institute for scoping reviews.


Seventy-seven articles were included in the thematic analysis; 71 were case reports, while the rest were case series and cross-sectional studies. The predominant finding in the PET/CT scans of the different pathologies was an increase in the uptake of various radiotracers, with [18F]FDG being the most commonly used. This diagnostic tool provided a comprehensive view of the systemic involvement of multiple conditions, such as Castleman disease and Cogan syndrome. It helped to identify the primary tumor and guide therapies for diseases like acromegaly.

Keywords: PET/CT, Autoimmune diseases, Rare diseases, Orphan diseases, [18F]FDG, Radiotracers, ICD-11, Nuclear medicine, Castleman disease, Cogan syndrome, Scoping review, Systemic involvement, Inflammation imaging, Joanna Briggs Institute, Molecular imaging

Article Details

How to Cite
SÁNCHEZ ORDÚZ, Liset; ACUÑA HERNANDEZ, Marylin; CORTÉS GERMÁN, Gerardo H.. Use of Pet/CT in different scenarios on rare and orphan diseases of autoimmune origin. Medical Research Archives, [S.l.], v. 12, n. 12, dec. 2024. ISSN 2375-1924. Available at: <https://esmed.org/MRA/mra/article/view/5994>. Date accessed: 06 jan. 2025. doi: https://doi.org/10.18103/mra.v12i12.5994.
Section
Review Articles

References

1. Rare diseases. World Health Organization. Accessed November 03, 2024. https://www.who.int/standards/classifications/frequently-asked-questions/rare-diseases

2. Rare Diseases at FDA. U.S. Food and Drug Administration. Updated December 12, 2022. Accessed November 03, 2024. https://www.fda.gov/patients/rare-diseases-fda

3. Rare diseases. European Commission. Accessed November 03, 2024. https://health.ec.europa.eu/rare-diseases-and-european-reference-networks/rare-diseases_en

4. Rare and Orphan Diseases. National Conference of State Legislatures. Updated May 26, 2023. Accessed November 03, 2024. https://www.ncsl.org/health/rare-and-orphan-diseases

5. What is Orphanet?. Orphanet. Updated October 14, 2023. Accessed November 03, 2024. https://www.orpha.net/es

6. The National Institute of Allergy and Infectious Diseases (NIAID). Autoimmune Diseases. Updated October 06, 2022. Accessed November 03, 2024. https://www.niaid.nih.gov/diseases-conditions/autoimmune-diseases

7. Autoimmune disease. National Cancer Institut (NIH). Accessed November 03, 2024. https://www.cancer.gov/publications/dictionaries/cancer-terms/def/autoimmune-disease

8. Miller FW. The increasing prevalence of autoimmunity and autoimmune diseases: an urgent call to action for improved understanding, diagnosis, treatment, and prevention. Curr Opin Immunol. 2023;80:102266. doi:10.1016/j.coi.2022. 102266.

9. Acuña M, Cortés QP, Sánchez L. Use of PET/CT as a diagnostic tool in various clinical scenarios related to systemic lupus erythematosus. Rev. Colomb. Reumatol. 2022;29(4): 331-334. doi:10.10 16/j.rcreue.2021.03.007.

10. Bashari WA, van der Meulen M, MacFarlane J, et al. 11C-methionine PET aids localization of microprolactinomas in patients with intolerance or resistance to dopamine agonist therapy. Pituitary. 2022;25(4):573-586. doi:10.1007/s11102-022-01229-9

11. Daniel KB, de Oliveira Santos A, de Andrade RA, Trentin MBF, Garmes HM. Evaluation of 68Ga-DOTATATE uptake at the pituitary region and the biochemical response to somatostatin analogs in acromegaly. J Endocrinol Invest. 2021;44(10):2195 -2202. doi:10.1007/s40618-021-01523-6

12. Daya R, Seedat F, Purbhoo K, Bulbulia S, Bayat Z. Acromegaly with empty sella syndrome. Endocrinol Diabetes Metab Case Rep. Published online July 1, 2021. doi:10.1530/EDM-21-0049

13. Saand AR, Alqaisi S, Gunaratne TN, Hasan S. Abstract #1003264: A Rare Case of Reversible Panhypopituitarism Secondary to Cavernous Internal Carotid Artery Aneurysm Successfully Treated with Pipeline Embolization. Endocr Pract. 2021 Jun;27(6):S121–2. doi: 10.1016/j.eprac.2021.04.727

14. Alsagheir O, Alobaid LA, Alswailem M, Al-Hindi H, Alzahrani AS. SAT613 A Novel NF1 Mutation As The Underlying Cause Of Dysmorphic Features And Acromegaly In An Atypical Case Of Neurofibromatosis Type 1. J Endocr Soc. 2023;7(Suppl 1):bvad114.1346. Published 2023 Oct 5. doi:10.1210/jendso/bvad114.1346

15. Haberbosch L, Gillett D, MacFarlane J, et al. Dual Role for l-[Methyl-11C]-Methionine PET in Acromegaly: Confirming Remission and Detecting Recurrence. J Nucl Med. 2024;65(2):327-328. Published 2024 Feb 1. doi:10.2967/jnumed.123.266446

16. Chiloiro S, Capoluongo ED, Costanza F, et al. The Pathogenic RET Val804Met Variant in Acromegaly: A New Clinical Phenotype?. Int J Mol Sci. 2024;25(3):1895. Published 2024 Feb 5. doi:10.3390/ijms25031895

17. Bakker LEH, Verstegen MJT, Manole DC, et al. 18F-fluoro-ethyl-tyrosine PET co-registered with MRI in patients with persisting acromegaly. Clin Endocrinol (Oxf). 2024;101(2):142-152. doi:10.11 11/cen.15079

18. Matsuki S, Taniuchi N, Okada N, et al. A Case of Immune Aplastic Anemia during Combined Treatment with Atezolizumab and Chemotherapy for Non-Small Cell Lung Cancer. J Nippon Med Sch. 2024;91(3):339-346. doi:10.1272/jnms.JNMS .2024_91-302

19. Dudek A, Riaz S, Priftakis D, Bomanji J. Pattern of Bone Marrow Hypometabolism on 18 F-FDG PET CT in Systemic Lupus Erythematous-Associated Aplastic Anemia. Clin Nucl Med. 2024;49(3):e113-e114. doi:10.1097/RLU.0000000000005033

20. Shrestha P, George MK, Baidya S, Rai SK. Bullous pemphigoid associated with squamous cell lung carcinoma showing remarkable response to carboplatin-based chemotherapy: a case report. J Med Case Rep. 2022;16(1):184. Published 2022 May 5. doi:10.1186/s13256-022-03323-9

21. Grünig H, Skawran SM, Nägeli M, Kamarachev J, Huellner MW. Immunotherapy (Cemiplimab)-Induced Bullous Pemphigoid: A Possible Pitfall in 18F-FDG PET/CT. Clin Nucl Med. 2022;47(2):185-186. doi:10.1097/RLU.0000000000003894

22. Moll-Bernardes RJ, de Oliveira RS, de Brito ASX, de Almeida SA, Rosado-de-Castro PH, de Sousa AS. Can PET/CT be useful in predicting ventricular arrhythmias in Chagas Disease?. J Nucl Cardiol. 2020;27(6):2417-2420. doi:10.1007/s1235 0-019-02014-1

23. de Oliveira RS, Moll-Bernardes R, de Brito AX, et al. Use of PET/CT to detect myocardial inflammation and the risk of malignant arrhythmia in chronic Chagas disease. J Nucl Cardiol. 2023;3 0(6):2702-2711. doi:10.1007/s12350-023-03350-z

24. Reddy Akepati NK, Abubakar ZA, Bikkina P. Role of 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Scan in Castleman's Disease. Indian J Nucl Med. 2018;33 (3):224-226. doi:10.4103/ijnm.IJNM_26_18

25. Liu M, Zhou J, Zhu W, Huo L, Cheng W. Mesenteric Castleman Disease Misdiagnosed as Lymph Node Metastasis of Rectal Cancer on 18 F-FDG PET/CT. Clin Nucl Med. 2023;48(11):985-986. doi:10.1097/RLU.0000000000004832

26. Zhang MY, Li J, Wang YN, Tian Z, Zhang L. Unicentric Castleman's disease presenting as amyloid A cardiac amyloidosis: a case report. Ann Hematol. 2024;103(1):367-368. doi:10.1007/s0027 7-023-05493-y

27. Maqbool S, Javed A, Idrees T, Anwar S. Unicentric Castleman Disease: A Rare Diagnosis of Radiological and Histological Correlation. Indian J Otolaryngol Head Neck Surg. 2023;75(2):975-978. doi:10.1007/s12070-022-03253-4

28. Yamauchi H, Momoki M, Kamiyama Y, et al. Hodgkin Lymphoma-related Inflammatory Modification-displayed Castleman Disease-like Histological Features and Positron Emission Tomography/Computed Tomography Usefulness for the Differential Diagnosis. Intern Med. 2024;63(7):993-998.

29. Zuo R, Xu L, Pang H. 68Ga-DOTATATE and 68Ga-Pentixafor PET/CT in a Patient with Castleman Disease of the Retroperitoneum. Diagnostics (Basel). 2024;14(4):372. Published 2024 Feb 8. doi:10.3390/diagnostics14040372

30. Aher P, Zughul R, Samtani S, Priya S, Siegel Y, Schettino C. Diaphragmatic Castleman's disease: A rare lymphoproliferative disorder: Clinical and radiological perspectives. Radiol Case Rep. 2024;19(12):6390-6393. Published 2024 Sep 25. doi:10.1016/j.radcr.2024.09.077

31. Mashal FA, Awad JA, Tillman BF, Mosse CA, Thandassery RB. Idiopathic Multicentric Castleman Disease With Thrombocytopenia, Anasarca, Fever, Reticulin Fibrosis/Renal Insufficiency, and Organomegaly (TAFRO) Syndrome in a Liver Transplant Recipient. ACG Case Rep J. 2024;11(8): e01446. Published 2024 Jul 27. doi:10.14309/crj. 0000000000001446

32. Hu S, Li Z, Zhang H, et al. Idiopathic multicentric Castleman disease and connective tissue disorder successfully treated by siltuximab: a pediatric case report. Transl Pediatr. 2024;13(5): 824-832. doi:10.21037/tp-23-605.

33. Choe YW, Chou E, Peker D. Multicentric Castleman Disease in the Setting of POEMS Syndrome. Clin Lymphoma Myeloma Leuk. 2024; 24(Suppl 1):S542. doi: 10.1016/S2152-2650(24)01655-0

34. Balink H, Bruyn GAW. The role of PET/CT in Cogan's syndrome. Clin Rheumatol. 2007;26 (12):2177-2179. doi:10.1007/s10067-007-0663-5

35. Orsal E, Uğur M, Seven B, Ayan AK, Içyer F, Yıldız A. The Importance of FDG-PET/CT in Cogan's Syndrome. Mol Imaging Radionucl Ther. 2014;23(2):74-75. doi:10.4274/mirt.349

36. Cabezas-Rodríguez I, Brandy-García A, Rodríguez-Balsera C, Rozas-Reyes P, Fernández-Llana B, Arboleya-Rodríguez L. Late-onset Cogan's syndrome associated with large-vessel vasculitis. Reumatol Clin (Engl Ed). 2019;15(5):e30-e32. doi:10.1016/j.reuma.2017.05.002.

37. Matsui Y, Makino T, Asano R, Hounoki H, Shimizu T. Immunohistochemical Examination of Cutaneous Vasculitis in a Case of Cogan's Syndrome. Indian J Dermatol. 2021;66(6):706. doi: 10.4103/ijd.ijd_882_20

38. Hafner S, Seufferlein T, Kleger A, Müller M. Aseptic Liver Abscesses as an Exceptional Finding in Cogan's Syndrome. Hepatology. 2021;73(5):20 67-2070. doi:10.1002/hep.31547.

39. Na G, Nan Z, Jingjing M, Lili P. A case report of Cogan's syndrome with recurrent coronary stenosis. Front Cardiovasc Med. 2024;11:1451113. Published 2024 Sep 12. doi:10.3389/fcvm.2024. 1451113

40. Lu C, Lv P, Zhu X, Han Y. Cogan's Syndrome Combined with Hypertrophic Pachymeningitis: A Case Report. J Inflamm Res. 2024;17:1839-1843. Published 2024 Mar 20. doi:10.2147/JIR.S453071

41. Nakamoto R, Okuyama C, Utsumi T, Yamamoto Y. Splenic Marginal Zone B-Cell Lymphoma With Splenic Infarction in a Patient With Cold Agglutinin Disease. Clin Nucl Med. 2019;44 (5):e372-e374. doi:10.1097/RLU.0000000000002528

42. Hayashi K, Koyama D, Sato Y, Fukatsu M, Ikezoe T. Lymphoplasmacytic lymphoma presenting cold agglutinin syndrome: Clonal expansion of KMT2D and IGHV4-34 mutations after COVID-19. Br J Haematol. 2023;203(5):e110-e113. doi:10. 1111/bjh.19106

43. Horiguchi Y, Tsurikisawa N, Harasawa A, et al. Detection of pulmonary involvement in eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA) with 18F-fluorodeoxyglucose positron emission tomography. Allergol Int. 2014;63(1):121-123. doi:10.2332/allergolint.13-LE-0550

44. Narváez J, Juarez P, Morales Ivorra I, Rodriguez Bel L, Rodriguez Moreno J, Romera M. [18F] FDG PET/CT may be a useful adjunct in diagnosis of eosinophilic fasciitis. Reumatol Clin (Engl Ed). 2019;15(6):e142-e143. doi:10.1016/j. reuma.2017.09.004.

45. Barlet J, Virone A, Gomez L, et al. 18F-FDG PET/CT and MRI findings of Shulman syndrome also known as eosinophilic fasciitis. Eur J Nucl Med Mol Imaging. 2021;48(6):2049-2050. doi:10.1007/ s00259-020-05172-4

46. Song Y, Zhang N, Yu Y. Diagnosis and treatment of eosinophilic fasciitis: Report of two cases. World J Clin Cases. 2021;9(29):8831-8838. doi:10.12998/wjcc.v9.i29.8831

47. Chalopin T, Vallet N, Morel M, et al. Eosinophilic fasciitis (Shulman syndrome), a rare entity and diagnostic challenge, as a manifestation of severe chronic graft-versus-host disease: a case report. J Med Case Rep. 2021;15(1):135. Published 2021 Mar 15. doi:10.1186/s13256-021-02735-3

48. Laria A, Lurati AM, Marrazza MG, Re K, Mazzocchi D, Faggioli P, et al. Ab1269 shulman’s disease or eosinophilic fasciitis, a rare fibrosing disorder: a case report treated with tocilizumab. Ann Rheum Dis. 2022 Jun;81(Suppl 1):1743.1-1743. doi: 10.1136/annrheumdis-2022-eular.119

49. Amrane K, Le Meur C, Thuillier P, et al. Case report: Eosinophilic fasciitis induced by pembrolizumab with high FDG uptake on 18F-FDG-PET/CT. Front Med (Lausanne). 2022;9:1078560. Published 2022 Dec 20. doi:10.3389/fmed.2022. 1078560

50. Benzaquen M, Christ L, Sutter N, Özdemir BC. Nivolumab-induced eosinophilic fasciitis: An unusual immune-related adverse event that needs to be recognized by practitioners. Ann Dermatol Venereol. 2023;150(4):304-307. doi:10.1016/j.ann der.2023.07.001

51. Fevrier A, Dufour PA. Eosinophilic Fasciitis Illustrated by 18 F-FDG PET/CT. Clin Nucl Med. 2024;49(4):e188-e190. doi:10.1097/RLU.00000000 00005094

52. Elliott L, Matthew Ho, Mediola I, 045 A rare cause of chest pain in a young female. J Rheumatol.2018;57(Suppl3):key075.269, doi:10.10 93/rheumatology/key075.269

53. Gultekin B, Torun E, Gul A, Kalayoglu-Besisik S. Cavitary primary pulmonary lymphoplasmocytic lymphoma complicating henoch–schönlein purpura. Hematol Transfus Cell Ther. 2021;43(S3) :S33-S65. Doi: 10.1016/j.htct.2021.10.1035

54. Razanamahery J, Humbert S, Emile JF, et al. Immune Thrombocytopenia Revealing Enriched IgG-4 Peri-Renal Rosai-Dorfman Disease Successfully Treated with Rituximab: A Case Report and Literature Review. Front Med (Lausanne). 2021;8:6 78456. Published 2021 Jun 16. doi:10.3389/fmed. 2021.678456.

55. Ren L, Liu W, Wu T, et al. Diffuse large B cell lymphoma and monoclonal gammopathy secondary to immune thrombocytopenic purpura: A case report. Oncol Lett. 2023;25(6):237. Published 2023 Apr 19. doi:10.3892/ol.2023.13823

56. Alkhaja MA, Cheng LTJ, Loi HY, Sinha AK. "Hot Cord" Sign on 18F-FDG PET/CT in a Patient With Acute Myelitis Due to Neuromyelitis Optica Spectrum Disorder. Clin Nucl Med. 2021;46(1):74-75. doi:10.1097/RLU.0000000000003367

57. Ding M, Lang Y, Cui L. AQP4-IgG positive paraneoplastic NMOSD: A case report and review. Brain Behav. 2021;11(10):e2282. doi:10.1002/brb 3.2282

58. Fujisawa C, Saji N, Takeda A, et al. Early-onset Alzheimer Disease Associated With Neuromyelitis Optica Spectrum Disorder. Alzheimer Dis Assoc Disord. 2023;37(1):85-87. doi:10.1097/WAD.0000 000000000517

59. Vlaicu C, Caloianu I, Sirbu C. Late-onset AQP4 positive neuromyelitis optica spectrum disorder – does it conceal a paraneoplastic syndrome?. IBRO Neurosci Rep. 2023;15:S292–3.doi:10.1016/j.ibne ur.2023.08.518

60. Dhull VS, Passah A, Rana N, Arora S, Mallick S, Kumar R. Paraneoplastic pemphigus as a first sign of metastatic retroperitoneal inflammatory myofibroblastic tumor: (18)F-FDG PET/CT findings. Rev Esp Med Nucl Imagen Mol. 2016;35(4):260-262. doi:10.1016/j.remn.2015.09.005

61. Lim JM, Kim JH, Hashimoto T, Kim SC. Lichenoid paraneoplastic pemphigus associated with follicular lymphoma without detectable autoantibodies. Clin Exp Dermatol. 2018;43(5):613 -615. doi:10.1111/ced.13563.

62. Khurana R, Sharma S, Kumar S, Deshpande AA, Wadhwa D, Agasty S. Paraneoplastic pemphigus associated with a pericardial ectopic thymoma. J Card Surg. 2020;35(11):3141-3144. doi:10.1111/ jocs.14955

63. Chen X, Fu Z, Yang X, Li Q. 18F-FDG PET/CT in Follicular Dendritic Cell Sarcoma With Paraneoplastic Pemphigus as the First Manifestation. Clin Nucl Med. 2020;45(7):572-574. doi:10.1097/RLU.0000000000003065.

64. Liska J, Liskova V, Trcka O, et al. Oral presentation of paraneoplastic pemphigus as the first sign of tonsillar HPV associated squamous cell carcinoma. A case report. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2022;166 (4):447-450. doi:10.5507/bp.2021.039.

65. Daniels P, Liou YL, Scarberry KB, Sharma TR, Korman NJ. Paraneoplastic pemphigus in a patient with a locally invasive, unresectable type B2 thymoma complicated by an intestinal perforation. JAAD Case Rep. 2023;35:103-107. Published 2023 Mar 24. doi:10.1016/j.jdcr.2023.03.006

66. Lu SC, Chu HL, Yueh HZ, Lin CH, Chou Y. Paraneoplastic pemphigus associated with nonhuman papillomavirus-related tonsillar squamous cell carcinoma: A case report. Medicine (Baltimore). 2024;103(36):e39368. doi:10.1097/ MD.0000000000039368

67. Fu Z, Liu M, Chen X, Yang X, Li Q. Paraneoplastic Pemphigus Associated With Castleman Disease Detected by 18F-FDG PET/CT. Clin Nucl Med. 2018;43(6):464-465. doi:10.1097/ RLU.0000000000002072

68. Liu QY, Chen MC, Chen XH, Gao M, Hu HJ, Li HG. Imaging characteristics of abdominal tumor in association with paraneoplastic pemphigus. Eur J Dermatol. 2011;21(1):83-88. doi:10.1684/ejd.2010.1187

69. Fu Z, Liu M, Chen X, Yang X, Li Q. Paraneoplastic Pemphigus Associated With Castleman Disease Detected by 18F-FDG PET/CT. Clin Nucl Med. 2018;43(6):464-465. doi:10.1097/ RLU.0000000000002072

70. Wang J, Wang X, Xu J, Song P. Follicular dendritic cell sarcoma aggravated by hyaline-vascular Castleman's disease in association with paraneoplastic pemphigus: study of the tumor and successful treatment. An Bras Dermatol. 2019;94(5) :578-581. doi:10.1016/j.abd.2019.09.009

71. Relvas M, Xará J, Lucas M, et al. Paraneoplastic pemphigus associated with Castleman's disease. J Paediatr Child Health. 2023;59(3):573-576. doi:10. 1111/jpc.16361

72. Rodriguez A, Tellez H, Martinez J, Pino Y. Paraneoplastic cerebellar degeneration secondary to HER2-positive breast cancer.J Neurol Sci. 2023; 455. (Suppl 121186). doi: https://doi.org/10.1016/j.jns.2023.121186

73. Takahashi N, Igari R, Iseki C, et al. Paraneoplastic Cerebellar Degeneration Accompanied by Seropositivity for Anti-GAD65, Anti-SOX-1 and Anti-VGCC Antibodies Due to Small-cell Lung Cancer. Intern Med. 2024;63(6): 857-860. doi:10.2169/internalmedicine.0738-22

74. Kalantari F, Schweighofer-Zwink G, Hecht S, Rendl G, Pirich C, Beheshti M. 18F-FDG PET/CT in assessment of paraneoplastic cerebellar degeneration as the first sign of occult fallopian tube serous cystadenocarcinoma: Case report. 18F-FDG PET/CT zur Beurteilung einer paraneoplastischen Kleinhirndegeneration als erstes Zeichen eines okkulten serösen Zystadenokarzinoms des Eileiters: Fallbericht. Rofo. 2024;196(8):850-851. doi:10.1055/a-2272-5346

75. Imai T, Shinohara K, Uchino K, et al. Paraneoplastic cerebellar degeneration with anti-Yo antibodies and an associated submandibular gland tumor: a case report. BMC Neurol. 2022; 22(1):165. Published 2022 May 2. doi:10.1186/s12 883-022-02684-4

76. Pan Q, Li J, Li F, Zhou D, Zhu Z. Characterizing POEMS Syndrome with 18F-FDG PET/CT. J Nucl Med. 2015;56(9):1334-1337. doi:10.2967/jnumed. 115.160507

77. Allam JS, Kennedy CC, Aksamit TR, Dispenzieri A. Pulmonary manifestations in patients with POEMS syndrome: a retrospective review of 137 patients. Chest. 2008;133(4):969-974. doi:10. 1378/chest.07-1800

78. Genicon C, Guilloton L, Pavic M, Le Moigne F. Skeletal lesions in POEMS syndrome. Joint Bone Spine. 2022;89(4):105324. doi:10.1016/j.jbspin.20 21.105324

79. Gültekin B, kaya B, Göksoy Y, Altinkaynak M, Öneç B, et al. GTCL-223 Clonal CD4+ Cytotoxic T Lymphocytosis Concomitant With POEMS Syndrome: A Co-Existence of Key Findings for Relevance in the Pathogenesis. Clin Lymphoma Myeloma Leuk. 2023;23(Suppl 1):S467-468. doi: https://doi.org/10.1016/S2152-2650(23)01390-3

80. Aderhold W, Lenz B, Hübner MP, et al. Intramedullary leukocytoclastic vasculitis and neutrophil extracellular trap (NET) formation in POEMS syndrome. Ann Hematol. 2024;103 (4):1415-1417. doi:10.1007/s00277-024-05651-w

81. Kang JH, Kim J. Polyarteritis nodosa presenting as leg pain with resolution of positron emission tomography-images: A case report. World J Clin Cases. 2023;11(4):918-921. doi:10.12 998/wjcc.v11.i4.918

82. Taimen K, Koskivirta I, Pirilä L, Mäkisalo H, Seppänen M, Allonen T. Polyarteritis nodosa with abdominal bleeding: imaging with PET/CT and angiography on the same day. Rheumatol Adv Pract. 2024;8(3):rkae095. Published 2024 Aug 6. doi:10.1093/rap/rkae095

83. Makiyama A, Abe Y, Furusawa H, et al. Polyarteritis nodosa diagnosed in a young male after COVID-19 vaccine: A case report. Mod Rheumatol Case Rep. 2023;8(1):125-132. doi:10.10 93/mrcr/rxad037

84. Philip R, Nganoa C, De Boysson H, Aouba A. 18FDG PET/CT: an aid for the early diagnosis of paucisymptomatic polyarteritis nodosa. Rheumatology (Oxford). 2024;63(6):e181-e182. doi:10.1093/rheumatology/kead655

85. Taniguchi Y, Yamamoto H. Muscular polyarteritis nodosa detected by FDG-PET/CT. Int J Rheum Dis. 2024;27(9):e15342. doi:10.1111/17 56-185X.15342

86. Khan G, Giacona J, Mirfakhraee S, Vernino S, Vongpatanasin W. MEN2B Masquerading as Postural Orthostatic Tachycardia Syndrome. JACC Case Rep. 2022;4(13):814-818. Published 2022 Jul 6. doi:10.1016/j.jaccas.2022.04.009

87. Diaz-Menindez M, Berianu F, Sullivan M. Incidental adenocarcinoma after bilateral lung transplant in a patient with scleroderma interstitial lung disease. J. Chest. 2023;164(4):a3405–6. doi: https://doi.org/10.1016/j.chest.2023.07.2214

88. Oh JR, Song HC, Kang SR, et al. The Clinical Usefulness of (18)F-FDG PET/CT in Patients with Systemic Autoimmune Disease. Nucl Med Mol Imaging. 2011;45(3):177-184. doi:10.1007/s13139 -011-0094-8

89. Wu C, Li F, Niu G, Chen X. PET imaging of inflammation biomarkers. Theranostics. 2013;3(7):4 48-466. Published 2013 Jun 24. doi:10.7150/thno.6592

90. Slart RHJA; Writing group; Reviewer group; FDG-PET/CT(A) imaging in large vessel vasculitis and polymyalgia rheumatica: joint procedural recommendation of the EANM, SNMMI, and the PET Interest Group (PIG), and endorsed by the ASNC. Eur J Nucl Med Mol Imaging. 2018;45(7): 1250-1269. doi:10.1007/s00259-018-3973-8

91. Jamar F, Buscombe J, Chiti A, et al. EANM/SNMMI guideline for 18F-FDG use in inflammation and infection. J Nucl Med. 2013;54(4) :647-658. doi:10.2967/jnumed.112.112524

92. Anzola LK, Glaudemans AWJM, Dierckx RAJO, Martinez FA, Moreno S, Signore A. Somatostatin receptor imaging by SPECT and PET in patients with chronic inflammatory disorders: a systematic review. Eur J Nucl Med Mol Imaging. 2019;46(12):2496-2513. doi:10.1007/s00259-019-04489-z.