Unusual [18F]FDG Avidity in multiple major arteries and pulmonary trunk: A case report of active large-vessel vasculitis

Articles in Press

Document Type : Case Report

Authors

1 Department of PET-CT Scan Center, Farabi Hospital, Isfahan University of Medical Sciences, Isfahan, Iran

2 Department of Medical Physics, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

10.22034/irjnm.2025.130081.1691

Abstract

Large-vessel vasculitis (LVV), including Takayasu arteritis and giant cell arteritis, is a rare inflammatory condition affecting the aorta and its major branches. This case report describes a 33-year-old male with fever of unknown origin (FUO), anemia, and elevated inflammatory markers. Initial imaging was inconclusive, but Fluorodeoxyglucose Positron Emission Tomography - Computed Tomography ([18F]FDG PET-CT) revealed diffuse uptake in major arteries (carotid, subclavian, brachiocephalic, aorta, and pulmonary trunk) with an SUVmax of 6.91, indicating active vasculitis. The absence of [18F]FDG-avid lymphadenopathy ruled out malignancy or infection, while faint uptake in bilateral femoral arteries suggested systemic involvement. Physiological uptake in organs like the gastrointestinal tract and adrenal glands showed no malignancy, and axial skeleton activity was linked to anemia. This case highlights [18F]FDG PET-CT's role in early LVV detection, stressing the need for timely diagnosis to prevent irreversible vascular damage and the importance of integrating imaging with clinical evaluation for effective management.

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References

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Iranian Journal of Nuclear Medicine

Articles in Press, Accepted Manuscript
Available Online from 30 December 2026

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