1
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Lee HJ, Bernau K, Harr TJ, Rosenkrans ZT, Kessler GA, Stott K, Oler AT, Rahar B, Zhu T, Medina-Guevara Y, Gupta N, Cho I, Gari MK, Burkel BM, Jeffery JJ, Weichmann AM, Tomasini-Johansson BR, Ponik SM, Engle JW, Hernandez R, Kwon GS, Sandbo N. [ 64Cu]Cu-PEG-FUD peptide for noninvasive and sensitive detection of murine pulmonary fibrosis. SCIENCE ADVANCES 2024; 10:eadj1444. [PMID: 38598637 PMCID: PMC11006221 DOI: 10.1126/sciadv.adj1444] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2023] [Accepted: 03/05/2024] [Indexed: 04/12/2024]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic lung disease resulting in irreversible scarring within the lungs. However, the lack of biomarkers that enable real-time assessment of disease activity remains a challenge in providing efficient clinical decision-making and optimal patient care in IPF. Fibronectin (FN) is highly expressed in fibroblastic foci of the IPF lung where active extracellular matrix (ECM) deposition occurs. Functional upstream domain (FUD) tightly binds the N-terminal 70-kilodalton domain of FN that is crucial for FN assembly. In this study, we first demonstrate the capacity of PEGylated FUD (PEG-FUD) to target FN deposition in human IPF tissue ex vivo. We subsequently radiolabeled PEG-FUD with 64Cu and monitored its spatiotemporal biodistribution via μPET/CT imaging in mice using the bleomycin-induced model of pulmonary injury and fibrosis. We demonstrated [64Cu]Cu-PEG-FUD uptake 3 and 11 days following bleomycin treatment, suggesting that radiolabeled PEG-FUD holds promise as an imaging probe in aiding the assessment of fibrotic lung disease activity.
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Affiliation(s)
- Hye Jin Lee
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705, USA
| | - Ksenija Bernau
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Thomas J. Harr
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Zachary T. Rosenkrans
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Grace A. Kessler
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Kristen Stott
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Angie Tebon Oler
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Babita Rahar
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Terry Zhu
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
| | - Yadira Medina-Guevara
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Nikesh Gupta
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705, USA
| | - Inyoung Cho
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705, USA
| | - Metti K. Gari
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Brian M. Burkel
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Justin J. Jeffery
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, USA
| | - Ashley M. Weichmann
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, USA
| | - Bianca R. Tomasini-Johansson
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
- Arrowhead Pharmaceuticals, 502 S. Rosa Rd., Madison, WI 53719, USA
| | - Suzanne M. Ponik
- Department of Cell and Regenerative Biology, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, USA
| | - Jonathan W. Engle
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Reinier Hernandez
- Department of Medical Physics, School of Medicine and Public Health, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI 53705, USA
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, USA
| | - Glen S. Kwon
- Pharmaceutical Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 777 Highland Avenue, Madison, WI 53705, USA
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, 1111 Highland Avenue, Madison, WI, USA
| | - Nathan Sandbo
- Division of Allergy, Pulmonary and Critical Care Medicine, Department of Medicine, School of Medicine and Public Health, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792, USA
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2
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Broens B, Duitman JW, Zwezerijnen GJC, Nossent EJ, van der Laken CJ, Voskuyl AE. Novel tracers for molecular imaging of interstitial lung disease: A state of the art review. Autoimmun Rev 2022; 21:103202. [PMID: 36150433 DOI: 10.1016/j.autrev.2022.103202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/16/2022] [Indexed: 12/14/2022]
Abstract
Interstitial lung disease is an overarching term for a wide range of disorders characterized by inflammation and/or fibrosis in the lungs. Most prevalent forms, among others, include idiopathic pulmonary fibrosis (IPF) and connective tissue disease associated interstitial lung disease (CTD-ILD). Currently, only disease modifying treatment options are available for IPF and progressive fibrotic CTD-ILD, leading to reduction or stabilization in the rate of lung function decline at best. Management of these patients would greatly advance if we identify new strategies to improve (1) early detection of ILD, (2) predicting ILD progression, (3) predicting response to therapy and (4) understanding pathophysiology. Over the last years, positron emission tomography (PET) and single photon emission computed tomography (SPECT) have emerged as promising molecular imaging techniques to improve ILD management. Both are non-invasive diagnostic tools to assess molecular characteristics of an individual patient with the potential to apply personalized treatment. In this review, we encompass the currently available pre-clinical and clinical studies on molecular imaging with PET and SPECT in IPF and CTD-ILD. We provide recommendations for potential future clinical applications of these tracers and directions for future research.
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Affiliation(s)
- Bo Broens
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
| | - Jan-Willem Duitman
- Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Department of Pulmonary Medicine, Meibergdreef 9, Amsterdam, the Netherlands; Amsterdam UMC location University of Amsterdam, Experimental Immunology (EXIM), Meibergdreef 9, Amsterdam, the Netherlands.
| | - Gerben J C Zwezerijnen
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Radiology and Nuclear Medicine, De Boelelaan 1117, Amsterdam, the Netherlands.
| | - Esther J Nossent
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Pulmonary Medicine, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Cardiovascular Sciences Research Institute, Amsterdam, the Netherlands..
| | - Conny J van der Laken
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
| | - Alexandre E Voskuyl
- Amsterdam UMC location Vrije Universiteit Amsterdam, Department of Rheumatology and Clinical Immunology, De Boelelaan 1117, Amsterdam, the Netherlands; Amsterdam Infection & Immunity, Inflammatory diseases, Amsterdam, the Netherlands.
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3
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Sawamura MVY, Kairalla RA, Buchpigel CA. PET/CT and interstitial lung disease. JORNAL BRASILEIRO DE PNEUMOLOGIA : PUBLICACAO OFICIAL DA SOCIEDADE BRASILEIRA DE PNEUMOLOGIA E TISILOGIA 2022; 48:e20220293. [PMID: 36074412 PMCID: PMC9496356 DOI: 10.36416/1806-3756/e20220293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
| | - Ronaldo Adib Kairalla
- . Divisão de Pneumologia, Instituto do Coração, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
| | - Carlos Alberto Buchpigel
- . Departamento de Radiologia e Oncologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo (SP) Brasil
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4
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Rosenkrans ZT, Massey CF, Bernau K, Ferreira CA, Jeffery JJ, Schulte JJ, Moore M, Valla F, Batterton JM, Drake CR, McMillan AB, Sandbo N, Pirasteh A, Hernandez R. [ 68 Ga]Ga-FAPI-46 PET for non-invasive detection of pulmonary fibrosis disease activity. Eur J Nucl Med Mol Imaging 2022; 49:3705-3716. [PMID: 35556159 DOI: 10.1007/s00259-022-05814-9] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 04/23/2022] [Indexed: 12/21/2022]
Abstract
PURPOSE The lack of effective molecular biomarkers to monitor idiopathic pulmonary fibrosis (IPF) activity or treatment response remains an unmet clinical need. Herein, we determined the utility of fibroblast activation protein inhibitor for positron emission tomography (FAPI PET) imaging in a mouse model of pulmonary fibrosis. METHODS Pulmonary fibrosis was induced by intratracheal administration of bleomycin (1 U/kg) while intratracheal saline was administered to control mice. Subgroups from each cohort (n = 3-5) underwent dynamic 1 h PET/CT after intravenously injecting FAPI-46 radiolabeled with gallium-68 ([68 Ga]Ga-FAPI-46) at 7 days and 14 days following disease induction. Animals were sacrificed following imaging for ex vivo gamma counting and histologic correlation. [68 Ga]Ga-FAPI-46 uptake was quantified and reported as percent injected activity per cc (%IA/cc) or percent injected activity (%IA). Lung CT density in Hounsfield units (HU) was also correlated with histologic examinations of lung fibrosis. RESULTS CT only detected differences in the fibrotic response at 14 days post-bleomycin administration. [68 Ga]Ga-FAPI-46 lung uptake was significantly higher in the bleomycin group than in control subjects at 7 days and 14 days. Significantly (P = 0.0012) increased [68 Ga]Ga-FAPI-46 lung uptake in the bleomycin groups at 14 days (1.01 ± 0.12%IA/cc) vs. 7 days (0.33 ± 0.09%IA/cc) at 60 min post-injection of the tracer was observed. These findings were consistent with an increase in both fibrinogenesis and FAP expression as seen in histology. CONCLUSION CT was unable to assess disease activity in a murine model of IPF. Conversely, FAPI PET detected both the presence and activity of lung fibrogenesis, making it a promising tool for assessing early disease activity and evaluating the efficacy of therapeutic interventions in lung fibrosis patients.
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Affiliation(s)
- Zachary T Rosenkrans
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA
| | - Christopher F Massey
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA
| | - Ksenija Bernau
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Carolina A Ferreira
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA
| | - Justin J Jeffery
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Jefree J Schulte
- Department of Pathology and Laboratory Medicine, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Jeanine M Batterton
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA
| | | | - Alan B McMillan
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA
| | - Nathan Sandbo
- Department of Medicine, Division of Allergy, Pulmonary and Critical Care Medicine, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI, USA
| | - Ali Pirasteh
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA.
- Department of Radiology, University of Wisconsin-Madison, 1111 Highland Ave., Room 2423, WI, 53705, Madison, USA.
| | - Reinier Hernandez
- Department of Medical Physics, University of Wisconsin-Madison, 1111 Highland Ave., Room 7137, WI, 53705, Madison, USA.
- University of Wisconsin Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, USA.
- Department of Radiology, University of Wisconsin-Madison, 1111 Highland Ave., Room 2423, WI, 53705, Madison, USA.
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5
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Kato T, Hiraishi Y, Kaseda K, Suzuki S, Tanaka G, Yamauchi Y, Yasui M, Shinozaki-Ushiku A, Ushiku T, Yamaji O, O'Neal WK, Nagase T. A 79-Year-Old Man With Progressive Dyspnea and Multiple Pulmonary Nodules. Chest 2021; 158:e79-e84. [PMID: 32768080 DOI: 10.1016/j.chest.2020.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 03/08/2020] [Accepted: 03/29/2020] [Indexed: 11/29/2022] Open
Affiliation(s)
- Takafumi Kato
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan; Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Yoshihisa Hiraishi
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan.
| | - Ken Kaseda
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Satoshi Suzuki
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Goh Tanaka
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Yasuhiro Yamauchi
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
| | - Mariko Yasui
- Departments of Pathology, The University of Tokyo Hospital, Tokyo, Japan; Department of Pathology, School of Medicine, Teikyo University, Tokyo, Japan
| | | | - Tetsuo Ushiku
- Departments of Pathology, The University of Tokyo Hospital, Tokyo, Japan
| | - Osamu Yamaji
- Department of Internal Medicine, Toshima Hospital of Tokyo Metropolitan Health and Hospitals Corporation, Tokyo, Japan
| | - Wanda K O'Neal
- Marsico Lung Institute, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Takahide Nagase
- Departments of Respiratory Medicine, The University of Tokyo Hospital, Tokyo, Japan
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6
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Tanguy J, Goirand F, Bouchard A, Frenay J, Moreau M, Mothes C, Oudot A, Helbling A, Guillemin M, Bonniaud P, Cochet A, Collin B, Bellaye PS. [ 18F]FMISO PET/CT imaging of hypoxia as a non-invasive biomarker of disease progression and therapy efficacy in a preclinical model of pulmonary fibrosis: comparison with the [ 18F]FDG PET/CT approach. Eur J Nucl Med Mol Imaging 2021; 48:3058-3074. [PMID: 33580818 PMCID: PMC8426306 DOI: 10.1007/s00259-021-05209-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 01/17/2021] [Indexed: 12/23/2022]
Abstract
Purpose Idiopathic pulmonary fibrosis (IPF) is a progressive disease with poor outcome and limited therapeutic options. Imaging of IPF is limited to high-resolution computed tomography (HRCT) which is often not sufficient for a definite diagnosis and has a limited impact on therapeutic decision and patient management. Hypoxia of the lung is a significant feature of IPF but its role on disease progression remains elusive. Thus, the aim of our study was to evaluate hypoxia imaging with [18F]FMISO as a predictive biomarker of disease progression and therapy efficacy in preclinical models of lung fibrosis in comparison with [18F]FDG. Methods Eight-week-old C57/BL6 mice received an intratracheal administration of bleomycin (BLM) at day (D) 0 to initiate lung fibrosis. Mice received pirfenidone (300 mg/kg) or nintedanib (60 mg/kg) by daily gavage from D9 to D23. Mice underwent successive PET/CT imaging at several stages of the disease (baseline, D8/D9, D15/D16, D22/D23) with [18F]FDG and [18F]FMISO. Histological determination of the lung expression of HIF-1α and GLUT-1 was performed at D23. Results We demonstrate that mean lung density on CT as well as [18F]FDG and [18F]FMISO uptakes are upregulated in established lung fibrosis (1.4-, 2.6- and 3.2-fold increase respectively). At early stages, lung areas with [18F]FMISO uptake are still appearing normal on CT scans and correspond to areas which will deteriorate towards fibrotic lesions at later timepoints. Nintedanib and pirfenidone dramatically and rapidly decreased mean lung density on CT as well as [18F]FDG and [18F]FMISO lung uptakes (pirfenidone: 1.2-, 2.9- and 2.6-fold decrease; nintedanib: 1.2-, 2.3- and 2.5-fold decrease respectively). Early [18F]FMISO lung uptake was correlated with aggressive disease progression and better nintedanib efficacy. Conclusion [18F]FMISO PET imaging is a promising tool to early detect and monitor lung fibrosis progression and therapy efficacy. Supplementary Information The online version contains supplementary material available at 10.1007/s00259-021-05209-2.
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Affiliation(s)
- Julie Tanguy
- INSERM U1231, Equipe HSP-pathies, 7 Boulevard Jeanne d'Arc, Dijon, France.,Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, réseau OrphaLung, Filère RespiFil. Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - Françoise Goirand
- INSERM U1231, Equipe HSP-pathies, 7 Boulevard Jeanne d'Arc, Dijon, France.,Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, réseau OrphaLung, Filère RespiFil. Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - Alexanne Bouchard
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France
| | - Jame Frenay
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France
| | - Mathieu Moreau
- Institut de Chimie Moléculaire de l'Université́ de Bourgogne, UMR CNRS 6302, Université de Bourgogne Franche-Comté, 21000, Dijon, France
| | | | - Alexandra Oudot
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France
| | - Alex Helbling
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France
| | - Mélanie Guillemin
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France
| | - Philippe Bonniaud
- INSERM U1231, Equipe HSP-pathies, 7 Boulevard Jeanne d'Arc, Dijon, France.,Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, réseau OrphaLung, Filère RespiFil. Centre Hospitalier Universitaire de Bourgogne, Dijon, France
| | - Alexandre Cochet
- Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France.,ImVIA, EA 7535, Université de Bourgogne, Dijon, France
| | - Bertrand Collin
- INSERM U1231, Equipe HSP-pathies, 7 Boulevard Jeanne d'Arc, Dijon, France.,Institut de Chimie Moléculaire de l'Université́ de Bourgogne, UMR CNRS 6302, Université de Bourgogne Franche-Comté, 21000, Dijon, France
| | - Pierre-Simon Bellaye
- Centre de Référence Constitutif des Maladies Pulmonaires Rares de l'Adultes de Dijon, réseau OrphaLung, Filère RespiFil. Centre Hospitalier Universitaire de Bourgogne, Dijon, France. .,Centre George François Leclerc, Service de médecine nucléaire, Plateforme d'imagerie et de radiothérapie précliniques, 1 rue du professeur Marion, Dijon, France.
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7
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Oishi H, Sakurada A, Notsuda H, Tanaka R, Takanami K, Saito R, Eba S, Noda M, Okada Y. Correlation between preoperative 18F-FDG PET/CT findings and postoperative short-term prognosis in lung cancer patients with idiopathic interstitial pneumonia after lung resection. Respir Investig 2021; 59:106-113. [PMID: 33004286 DOI: 10.1016/j.resinv.2020.08.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/06/2020] [Accepted: 08/19/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The present study aimed to investigate the correlation between preoperative 2-deoxy-2-[18F]fluoro-d-glucose (18F-FDG) PET/CT findings and short-term survival in lung cancer patients with idiopathic interstitial pneumonia (IIP). METHODS We retrospectively reviewed the data of 425 patients who underwent lung resection for non-small cell lung cancer without preoperative radiation therapy between November 2012 and October 2017. The maximum SUV (SUVmax) in the IIP area except the lung cancer site was measured in each patient. RESULTS Thirty-one of the 425 patients (7.3%) showed findings of IIP in chest CT. Five of the 31 patients (16.1%) developed acute exacerbation (AE) after lung resection (AE+ group). Twenty-six of the 31 patients (83.9%) did not develop AE (AE- group). In the AE+ group, 18F-FDG SUVmax in the IIP area was significantly higher (1.9 ± 0.6 vs. 2.7 ± 0.7, p = 0.02) compared with that in the AE- group. The receiver operating characteristic analysis identified an SUVmax threshold score of 2.55 (p = 0.02) for AE. There was no 90-day mortality in the patients with SUVmax < 2.55 (n = 25). On the other hand, the 90-day mortality rate in patients with SUVmax ≥ 2.55 (n = 6) was 33.3% (2 patients). CONCLUSIONS 18F-FDG PET/CT may predict AE after lung resection and could be related to short-term survival in lung cancer patients with IIP. Further investigations are needed to improve the prognosis in patients with high SUVmax in the IIP area.
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Affiliation(s)
- Hisashi Oishi
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan.
| | - Akira Sakurada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Hirotsugu Notsuda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Ryota Tanaka
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Kentaro Takanami
- Department of Radiology, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Ryoko Saito
- Department of Pathology, Tohoku University Graduate School of Medicine, 2-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Shunsuke Eba
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Masafumi Noda
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
| | - Yoshinori Okada
- Department of Thoracic Surgery, Institute of Development, Aging and Cancer, Tohoku University, 4-1 Seiryomachi, Aobaku, Sendai, 980-8575, Japan
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8
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Peelen DM, Zwezerijnen BGJC, Nossent EJ, Meijboom LJ, Hoekstra OS, Van der Laken CJ, Voskuyl AE. The quantitative assessment of interstitial lung disease with positron emission tomography scanning in systemic sclerosis patients. Rheumatology (Oxford) 2020; 59:1407-1415. [PMID: 31642912 PMCID: PMC7244784 DOI: 10.1093/rheumatology/kez483] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/25/2019] [Indexed: 02/06/2023] Open
Abstract
Objectives The reversibility of interstitial lung disease (ILD) in SSc is difficult to assess by current diagnostic modalities and there is clinical need for imaging techniques that allow for treatment stratification and monitoring. 18F-Fluorodeoxyglucose (FDG) PET/CT scanning may be of interest for this purpose by detection of metabolic activity in lung tissue. This study aimed to investigate the potential role of 18F-FDG PET/CT scanning for the quantitative assessment of SSc-related active ILD. Methods 18F-FDG PET/CT scans and high resolution CT scans of eight SSc patients, including five with ILD, were analysed. For comparison, reference groups were included: eight SLE patients and four primary Sjögren’s syndrome (pSS) patients, all without ILD. A total of 22 regions of interest were drawn in each patient at apical, medial and dorsobasal lung levels. 18F-FDG uptake was measured as mean standardized uptake value (SUVmean) in each region of interest. Subsequently, basal/apical (B/A) and medial/apical (M/A) ratios were calculated at patient level (B/A-p and M/A-p) and at tissue level (B/A-t and M/A-t). Results SUVmean values in dorsobasal ROIs and B/A-p ratios were increased in SSc with ILD compared with SSc without ILD (P = 0.04 and P = 0.07, respectively), SLE (P = 0.003 and P = 0.002, respectively) and pSS (P = 0.03 and P = 0.02, respectively). Increased uptake in the dorsobasal lungs and increased B/A-t ratios corresponded to both ground glass and reticulation on high resolution CT. Conclusion Semi-quantitative assessment of 18F-FDG PET/CT is able to distinguish ILD from non-affected lung tissue in SSc, suggesting that it may be used as a new biomarker for SSc-ILD disease activity.
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Affiliation(s)
- Daphne M Peelen
- Department of Rheumatology, Amsterdam Rheumatology & Immunology Center
| | | | - Esther J Nossent
- Department of Pulmonary Medicine and Amsterdam Cardiovascular Sciences, Amsterdam UMC, Vrije Universiteit, Amsterdam, The Netherlands
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9
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Xiong Y, Nie D, Liu S, Ma H, Su S, Sun A, Zhao J, Zhang Z, Xiang X, Tang G. Apoptotic PET Imaging of Rat Pulmonary Fibrosis With [ 18F]ML-8. Mol Imaging 2019; 17:1536012118795728. [PMID: 30348035 PMCID: PMC6201178 DOI: 10.1177/1536012118795728] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Objective: To investigate the value of 2-(3-[18F]fluoropropyl)-2-methyl-malonic acid
([18F]ML-8) positron emission tomography (PET) imaging of rat pulmonary
fibrosis. Methods: Male Sprague-Dawley rats were divided into 2 groups, including pulmonary fibrosis model
group and control group. The rat model was established by an intratracheal instillation
of bleomycin (BLM). Control rats were treated with saline. Positron emission
tomography/computed tomography (CT) with [18F]ML-8 or
18F-fluorodeoxyglucose ([18F]FDG) was performed on 2 groups. After
PET/CT imaging, lung tissues were collected for histologic examination. Data were
analyzed and comparisons between 2 groups were performed using Student
t test. Results: Bleomycin-treated rats showed a higher lung uptake of [18F]ML-8 than control
rats (P < .05). In BLM-treated rats, the lung to muscle relative
uptake ratio of [18F]ML-8 was also higher than that of [18F]FDG
(P < .05). Pathological examination showed overproliferation of
fibroblasts and deposition of collagen in lungs from BLM-treated rats. Compared to
control rats, BLM-treated rats had higher lung hydroxyproline content
(P < .05). Immunofluorescence staining indicated more apoptotic
cells in BLM-treated rats than those in control rats. Moreover, the apoptosis rate of
lung tissues obtained from BLM-treated rats was higher than that from control rats
(P < .05). Conclusions: 2-(3-[18F]fluoropropyl)-2-methyl-malonic acid PET/CT could be used for
noninvasive diagnosis of pulmonary fibrosis in a rat model.
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Affiliation(s)
- Ying Xiong
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Dahong Nie
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoyu Liu
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Hui Ma
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shu Su
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Aixia Sun
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Jing Zhao
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Zhanwen Zhang
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xianhong Xiang
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ganghua Tang
- 1 Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals and Department of Medical Imaging, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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10
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Xiong Y, Nie D, Liu S, Ma H, Su S, Sun A, Zhao J, Zhang Z, Xiang X, Tang G. Apoptotic PET Imaging of Rat Pulmonary Fibrosis with Small-Molecule Radiotracer. Mol Imaging Biol 2018; 21:491-499. [PMID: 30167994 DOI: 10.1007/s11307-018-1242-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE The purpose of this study was to assess the potential utility of small-molecule apoptotic radiotracer, 2-(5-[18F]fluoropentyl)-2-methyl malonic acid ([18F]ML-10), for positron emission tomography (PET)/computed tomography (CT) monitoring the progression of pulmonary fibrosis in a rat model. PROCEDURES Male Sprague-Dawley rats were used to establish a rat model of pulmonary fibrosis by means of bleomycin (BLM) administration; control rats received saline (n = 12 per group). PET/CT with [18F]ML-10 and 2-deoxy-2-[18F]fluoro-D-glucose ([18F]FDG) was performed in two groups at different stages of pulmonary fibrosis. The fibrotic response and the cell apoptosis were assessed with histologic examination. Differences in the apoptosis rate, fibrotic activity, and the lung uptake of [18F]ML-10 and [18F]FDG between two groups were determined with Student t test. RESULTS Compared with control group, BLM group showed a higher lung uptake of [18F]ML-10 at all imaging time points (all P < 0.001). During the fibrotic phase of this disease model (days 21 and 28), the lung uptake of [18F]ML-10 was higher than that of [18F]FDG in the BLM group (all P < 0.001). Moreover, accumulation of [18F]ML-10 in the lung tissues increased in proportion to the apoptosis rate (R2 = 0.9863, P < 0.0001) and fibrotic activity (R2 = 0.9631, P < 0.0001) of rat pulmonary fibrosis. Conversely, no correlation between [18F]FDG uptake and fibrotic activity was found. CONCLUSIONS [18F]ML-10 PET/CT enabled monitoring the progression of rat pulmonary fibrosis, whereas [18F]FDG PET/CT could not. Implications for noninvasive diagnosis of pulmonary fibrosis, assessment of fibrotic activity, and evaluation of antifibrotic therapy are expected.
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Affiliation(s)
- Ying Xiong
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Dahong Nie
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Shaoyu Liu
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Hui Ma
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Shu Su
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Aixia Sun
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Jing Zhao
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Zhanwen Zhang
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China
| | - Xianhong Xiang
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China.
| | - Ganghua Tang
- Department of Medical Imaging and Guangdong Engineering Research Center for Translational Application of Medical Radiopharmaceuticals, The First Affiliated Hospital, Sun Yat-sen University, 58 Zhongshan Road II, Guangzhou, 510080, China.
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11
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Robbie H, Daccord C, Chua F, Devaraj A. Evaluating disease severity in idiopathic pulmonary fibrosis. Eur Respir Rev 2017; 26:26/145/170051. [PMID: 28877976 DOI: 10.1183/16000617.0051-2017] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2017] [Accepted: 06/16/2017] [Indexed: 12/27/2022] Open
Abstract
Accurate assessment of idiopathic pulmonary fibrosis (IPF) disease severity is integral to the care provided to patients with IPF. However, to date, there are no generally accepted or validated staging systems. There is an abundance of data on using information acquired from physiological, radiological and pathological parameters, in isolation or in combination, to assess disease severity in IPF. Recently, there has been interest in using serum biomarkers and computed tomography-derived quantitative lung fibrosis measures to stage disease severity in IPF. This review will focus on the suggested methods for staging IPF, at baseline and on serial assessment, their strengths and limitations, as well as future developments.
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Affiliation(s)
- Hasti Robbie
- Radiology Dept, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Cécile Daccord
- Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK.,Respiratory Medicine, University Hospital of Lausanne, Lausanne, Switzerland
| | - Felix Chua
- Interstitial Lung Disease Unit, Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | - Anand Devaraj
- Centre for Academic Radiology, Royal Brompton Hospital, London, UK
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12
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Desai U, Karkhanis VS, Basu S, Joshi JM. Fluorine-18 fluorodeoxyglucose positron emission tomography/computed tomography in idiopathic pulmonary fibrosis: A new ray of hope! Indian J Nucl Med 2016; 31:283-285. [PMID: 27833314 PMCID: PMC5041417 DOI: 10.4103/0972-3919.187456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive interstitial lung disease with median survival of 2-3 years. It is described as fibroproliferative rather than pro-inflammatory disorder with limited treatment options. IPF diagnostics and therapeutics are a hot topic of current research. We describe a case elaborating the utility of the whole body positron emission tomography with 2-deoxy-2-(fluorine-18) fluoro-D-glucose (F-18 FDG) integrated with computed tomography technique in IPF. The area of most intense pulmonary F--18 FDG uptake corresponded to regions of honeycombing suggesting metabolically active disease amenable to pharmacologic intervention. Additional F--18 FDG uptake was seen in mediastinal nodes implying an extrapulmonary component of disease.
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Affiliation(s)
- Unnati Desai
- Department of Pulmonary Medicine, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
| | - Vinaya S Karkhanis
- Radiation Medicine Centre (BARC), Tata Memorial Hospital Annexe, Parel, Mumbai, Maharashtra, India
| | - Sandip Basu
- Radiation Medicine Centre (BARC), Tata Memorial Hospital Annexe, Parel, Mumbai, Maharashtra, India
| | - Jyotsna M Joshi
- Department of Pulmonary Medicine, Topiwala National Medical College and B. Y. L. Nair Hospital, Mumbai, Maharashtra, India
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13
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Yu-Wai-Man C, Khaw PT. Personalized Medicine in Ocular Fibrosis: Myth or Future Biomarkers. Adv Wound Care (New Rochelle) 2016; 5:390-402. [PMID: 27679750 PMCID: PMC5028906 DOI: 10.1089/wound.2015.0677] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2015] [Accepted: 02/04/2016] [Indexed: 02/06/2023] Open
Abstract
Significance: Fibrosis-related events play a part in the pathogenesis or failure of treatment of virtually all the blinding diseases around the world, and also account for over 40% of all deaths. It is well established that the eye and other tissues of some group of patients, for example Afro-Caribbean people, scar worse than others. However, there is a current lack of reliable biomarkers to stratify the risk of scarring and postsurgical fibrosis in the eye. Recent Advances: Recent studies using genomics, proteomics, metabolomics, clinical phenotyping, and high-resolution in vivo imaging techniques have revealed potential novel biomarkers to identify and stratify patients at risk of scarring in different fibrotic eye diseases. Critical Issues: Most of the studies, to date, have been done in animals or small cohorts of patients and future research is needed to validate these results in large longitudinal human studies. Detailed clinical phenotyping and effective biobanking of patient tissues will also be critical for future biomarker research in ocular fibrosis. Future Directions: The ability to predict the risk of scarring and to tailor the antifibrotic treatment regimen to each individual patient will be an extremely useful tool clinically to prevent undertreating, or exposing patients to unnecessary treatments with potential side effects. An exciting future prospect will be to use new advances in genotyping, namely next-generation whole genome sequencing like RNA-Seq, to develop a customized gene chip in ocular fibrosis. Successful translation of future biomarkers to benefit patient care will also ultimately require a strong collaboration between academics, pharmaceutical, and biotech companies.
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Affiliation(s)
- Cynthia Yu-Wai-Man
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
| | - Peng Tee Khaw
- National Institute for Health Research (NIHR) Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom
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14
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Chaudhuri AA, Binkley MS, Rigdon J, Carter JN, Aggarwal S, Dudley SA, Qian Y, Kumar KA, Hara WY, Gensheimer M, Nair VS, Maxim PG, Shultz DB, Bush K, Trakul N, Le QT, Diehn M, Loo BW, Guo HH. Pre-treatment non-target lung FDG-PET uptake predicts symptomatic radiation pneumonitis following Stereotactic Ablative Radiotherapy (SABR). Radiother Oncol 2016; 119:454-60. [PMID: 27267049 DOI: 10.1016/j.radonc.2016.05.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 05/09/2016] [Accepted: 05/16/2016] [Indexed: 12/25/2022]
Abstract
PURPOSE To determine if pre-treatment non-target lung FDG-PET uptake predicts for symptomatic radiation pneumonitis (RP) following lung stereotactic ablative radiotherapy (SABR). METHODS We reviewed a 258 patient database from our institution to identify 28 patients who experienced symptomatic (grade ⩾ 2) RP after SABR, and compared them to 57 controls who did not develop symptomatic RP. We compared clinical, dosimetric and functional imaging characteristics between the 2 cohorts including pre-treatment non-target lung FDG-PET uptake. RESULTS Median follow-up time was 26.9 months. Patients who experienced symptomatic RP had significantly higher non-target lung FDG-PET uptake as measured by mean SUV (p < 0.0001) than controls. ROC analysis for symptomatic RP revealed area under the curve (AUC) of 0.74, with sensitivity 82.1% and specificity 57.9% with cutoff mean non-target lung SUV > 0.56. Predictive value increased (AUC of 0.82) when mean non-target lung SUV was combined with mean lung dose (MLD). We developed a 0-2 point model using these 2 variables, 1 point each for SUV > 0.56 or MLD > 5.88 Gy equivalent dose in 2 Gy per fraction (EQD2), predictive for symptomatic RP in our cohort with hazard ratio 10.01 for score 2 versus 0 (p < 0.001). CONCLUSIONS Patients with elevated pre-SABR non-target lung FDG-PET uptake are at increased risk of symptomatic RP after lung SABR. Our predictive model suggests patients with mean non-target lung SUV > 0.56 and MLD > 5.88 Gy EQD2 are at highest risk. Our predictive model should be validated in an external cohort before clinical implementation.
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Affiliation(s)
- Aadel A Chaudhuri
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Michael S Binkley
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Joseph Rigdon
- Quantitative Sciences Unit, Stanford University School of Medicine, United States
| | - Justin N Carter
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Sonya Aggarwal
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Sara A Dudley
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Yushen Qian
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Kiran A Kumar
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Wendy Y Hara
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - Michael Gensheimer
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Viswam S Nair
- Department of Medicine, Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, United States
| | - Peter G Maxim
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - David B Shultz
- Department of Radiation Oncology, University of Toronto, Princess Margaret Cancer Centre, Canada
| | - Karl Bush
- Department of Radiation Oncology, Stanford University School of Medicine, United States
| | - Nicholas Trakul
- Department of Radiation Oncology, University of Southern California School of Medicine, United States
| | - Quynh-Thu Le
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States
| | - Maximilian Diehn
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States; Institute for Stem Cell Biology & Regenerative Medicine, Stanford University School of Medicine, United States.
| | - Billy W Loo
- Department of Radiation Oncology, Stanford University School of Medicine, United States; Stanford Cancer Institute, Stanford University School of Medicine, United States.
| | - Haiwei Henry Guo
- Department of Radiology and Nuclear Medicine, Stanford University School of Medicine, United States.
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15
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Cha MJ, Lee KS, Hwang HS, Kim TJ, Kim TS, Kim BT, Ko YH, Shim YM. Pulmonary Intravascular Lymphomatosis: Clinical, CT, and PET Findings, Correlation of CT and Pathologic Results, and Survival Outcome. Radiology 2016; 280:602-10. [PMID: 26943231 DOI: 10.1148/radiol.2016151706] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Purpose To describe clinical, computed tomographic (CT), and positron emission tomographic (PET) features, correlation of CT and pathologic results, and survival of patients with pulmonary intravascular lymphomatosis. Materials and Methods The institutional review board approved this retrospective study with waiver of patient consent. Forty-two patients with pulmonary intravascular lymphomatosis were identified, 11 (26%) of whom showed lung involvement. CT features were correlated with histopathologic results. Clinical and survival outcomes were compared between patients with and those without pulmonary involvement by adopting the χ(2), Student t, or Kaplan-Meier analysis with log-rank tests. Results At clinical presentation, all 11 patients showed B symptoms (systemic symptoms of fever, night sweats, and weight loss), 10 had respiratory and four had neurologic symptoms, and two had skin lesions. Patients received cyclophosphamide, doxorubicin, vincristine, and prednisone chemotherapy with (n = 5) or without (n = 6) rituximab, and seven (64%) patients died. Patients with lung involvement showed reduced overall and recurrence-free survival (median; 10.8 and 18.9 months, respectively) compared with those without lung involvement (median, 18.4 and 31.0 months, respectively) (P = .338 and .065, respectively). The most common CT abnormality was bilateral ground-glass opacity (GGO, n = 10), with increased fluorodeoxyglucose uptake at PET/CT (seven of seven patients). GGO correlated histopathologically with the expanded alveolar septal vasculatures and perivascular spaces filled with neoplastic lymphoid cells. Conclusion Pulmonary intravascular lymphomatosis appeared as bilateral GGO on CT images, with increased fluorodeoxyglucose uptake on PET/CT images. GGO on CT images correlated with the area of expanded alveolar septae because of distended vessels filled with neoplastic lymphoid cells. (©) RSNA, 2016 Online supplemental material is available for this article.
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Affiliation(s)
- Min Jae Cha
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Kyung Soo Lee
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Hye Sun Hwang
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Tae Jung Kim
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Tae Sung Kim
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Byung-Tae Kim
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Young-Hyeh Ko
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
| | - Young Mog Shim
- From the Department of Radiology and Center for Imaging Science (M.J.C., K.S.L., H.S.H., T.J.K., T.S.K.), Department of Nuclear Medicine (B.T.K.), Department of Pathology (Y.H.K.), and Department of Thoracic Surgery (Y.M.S.), Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea
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16
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Iyer K, Karkhanis V, Basu S, Joshi JM. Fluro-deoxygenase-positron emission tomography/computed tomography in hard metal lung disease. Lung India 2015; 32:480-2. [PMID: 26628763 PMCID: PMC4587003 DOI: 10.4103/0970-2113.164160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
We report a case of a diamond polisher where FDG-PET/CT was helpful in identifying active inflammation in hard metal lung disease (HMLD) caused by cobalt exposure.
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Affiliation(s)
- Kapil Iyer
- Department of Pulmonary Medicine, Topiwala National Medical College, BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Vinaya Karkhanis
- Department of Pulmonary Medicine, Topiwala National Medical College, BYL Nair Hospital, Mumbai, Maharashtra, India
| | - Sandip Basu
- Department of Nuclear Medicine, Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital, Mumbai, Maharashtra, India
| | - Jyotsna M Joshi
- Department of Pulmonary Medicine, Topiwala National Medical College, BYL Nair Hospital, Mumbai, Maharashtra, India
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17
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Umeda Y, Demura Y, Morikawa M, Anzai M, Kadowaki M, Ameshima S, Tsuchida T, Tsujikawa T, Kiyono Y, Okazawa H, Ishizaki T, Ishizuka T. Prognostic Value of Dual-Time-Point 18F-FDG PET for Idiopathic Pulmonary Fibrosis. J Nucl Med 2015; 56:1869-75. [PMID: 26359263 DOI: 10.2967/jnumed.115.163360] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Accepted: 09/02/2015] [Indexed: 11/16/2022] Open
Abstract
UNLABELLED The aim of this prospective study was to clarify whether dual-time-point (18)F-FDG PET imaging results are useful to predict long-term survival of idiopathic pulmonary fibrosis (IPF) patients. METHODS Fifty IPF patients underwent (18)F-FDG PET examinations at 2 time points: 60 min (early imaging) and 180 min (delayed imaging) after (18)F-FDG injection. The standardized uptake value (SUV) at each point and retention index value (RI-SUV) calculated from those were evaluated, and then the results were compared with overall and progression-free survival. RESULTS A multivariate Cox proportional hazards model showed higher RI-SUV and higher extent of fibrosis score as independent predictors of shorter progression-free survival. The median progression-free survival for patients with negative RI-SUV was better than that for those with positive RI-SUV (27.9 vs. 13.3 mo, P = 0.0002). On the other hand, multivariate Cox analysis showed higher RI-SUV and lower forced vital capacity to be independent predictors of shorter overall survival. The 5-y survival rate for patients with negative RI-SUV was better than that for those with positive RI-SUV (76.8% vs. 14.3%, P = 0.00001). In addition, a univariate Cox model showed that positive RI-SUV as a binary variable was a significant indicator of mortality (hazard ratio, 7.31; 95% confidence interval, 2.64-20.3; P = 0.0001). CONCLUSION Our results demonstrate that positive RI-SUV is strongly predictive of earlier deterioration of pulmonary function and higher mortality in patients with IPF.
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Affiliation(s)
- Yukihiro Umeda
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Yoshiki Demura
- Department of Respiratory Medicine, Fukui Red Cross Hospital, Fukui-shi, Fukui, Japan
| | - Miwa Morikawa
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Masaki Anzai
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Maiko Kadowaki
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Shingo Ameshima
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Tatsuro Tsuchida
- Department of Radiology, University of Fukui, Yoshida-gun, Fukui, Japan
| | - Tetsuya Tsujikawa
- Biomedical Imaging Research Center, University of Fukui, Yoshida-gun, Fukui, Japan; and
| | - Yasushi Kiyono
- Biomedical Imaging Research Center, University of Fukui, Yoshida-gun, Fukui, Japan; and
| | - Hidehiko Okazawa
- Biomedical Imaging Research Center, University of Fukui, Yoshida-gun, Fukui, Japan; and
| | - Takeshi Ishizaki
- Respiratory Diseases Center of Northern Noto Area, Ishikawa Prefecture, Anamizu-cho, Ishikawa, Japan
| | - Tamotsu Ishizuka
- Third Department of Internal Medicine, University of Fukui, Yoshida-gun, Fukui, Japan
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Flechsig P, Mehndiratta A, Haberkorn U, Kratochwil C, Giesel FL. PET/MRI and PET/CT in Lung Lesions and Thoracic Malignancies. Semin Nucl Med 2015; 45:268-81. [DOI: 10.1053/j.semnuclmed.2015.03.004] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Bondue B, Sherer F, Van Simaeys G, Doumont G, Egrise D, Yakoub Y, Huaux F, Parmentier M, Rorive S, Sauvage S, Lacroix S, Vosters O, De Vuyst P, Goldman S. PET/CT with 18F-FDG- and 18F-FBEM-labeled leukocytes for metabolic activity and leukocyte recruitment monitoring in a mouse model of pulmonary fibrosis. J Nucl Med 2015; 56:127-32. [PMID: 25537989 DOI: 10.2967/jnumed.114.147421] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
UNLABELLED Idiopathic pulmonary fibrosis is characterized by a progressive and irreversible respiratory failure. Validated noninvasive methods able to assess disease activity are essential for prognostic purposes as well as for the evaluation of emerging antifibrotic treatments. METHODS C57BL/6 mice were used in a murine model of pulmonary fibrosis induced by an intratracheal instillation of bleomycin (control mice were instilled with a saline solution). At different times after instillation, PET/CT with (18)F-FDG- or (18)F-4-fluorobenzamido-N-ethylamino-maleimide ((18)F-FBEM)-labeled leukocytes was performed to assess metabolic activity and leukocyte recruitment, respectively. RESULTS In bleomycin-treated mice, a higher metabolic activity was measured on (18)F-FDG PET/CT scans from day 7 to day 24 after instillation, with a peak of activity measured at day 14. Of note, lung mean standardized uptake values correlated with bleomycin doses, histologic score of fibrosis, lung hydroxyproline content, and weight loss. Moreover, during the inflammatory phase of the model (day 7), but not the fibrotic phase (day 23), bleomycin-treated mice presented with an enhanced leukocyte recruitment as assessed by (18)F-FBEM-labeled leukocyte PET/CT. Autoradiographic analysis of lung sections and CD45 immunostaining confirm the higher and early recruitment of leukocytes in bleomycin-treated mice, compared with control mice. CONCLUSION (18)F-FDG- and (18)F-FBEM-labeled leukocyte PET/CT enable monitoring of metabolic activity and leukocyte recruitment in a mouse model of pulmonary fibrosis. Implications for preclinical evaluation of antifibrotic therapy are expected.
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Affiliation(s)
- Benjamin Bondue
- Service de Pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (I.R.I.B.H.M.), Université Libre de Bruxelles, Brussels, Belgium
| | - Félicie Sherer
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
| | - Gaetan Van Simaeys
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
| | - Gilles Doumont
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
| | - Dominique Egrise
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
| | - Yousof Yakoub
- Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - François Huaux
- Centre for Toxicology and Applied Pharmacology, Université Catholique de Louvain, Louvain-la-Neuve, Belgium
| | - Marc Parmentier
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (I.R.I.B.H.M.), Université Libre de Bruxelles, Brussels, Belgium
| | - Sandrine Rorive
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium
| | - Sébastien Sauvage
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium
| | - Simon Lacroix
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
| | - Olivier Vosters
- Institut de Recherche Interdisciplinaire en Biologie Humaine et Moléculaire (I.R.I.B.H.M.), Université Libre de Bruxelles, Brussels, Belgium
| | - Paul De Vuyst
- Service de Pneumologie, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Serge Goldman
- Center for Microscopy and Molecular Imaging, Université Libre de Bruxelles, Gosselies, Belgium Service de Médecine Nucléaire, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium; and
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Win T, Thomas BA, Lambrou T, Hutton BF, Screaton NJ, Porter JC, Maher TM, Endozo R, Shortman RI, Afaq A, Lukey P, Ell PJ, Groves AM. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients. Eur J Nucl Med Mol Imaging 2014; 41:337-42. [PMID: 23942907 PMCID: PMC3890564 DOI: 10.1007/s00259-013-2514-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 07/07/2013] [Indexed: 11/07/2022]
Abstract
PURPOSE Patients with idiopathic pulmonary fibrosis (IPF) show increased PET signal at sites of morphological abnormality on high-resolution computed tomography (HRCT). The purpose of this investigation was to investigate the PET signal at sites of normal-appearing lung on HRCT in IPF. METHODS Consecutive IPF patients (22 men, 3 women) were prospectively recruited. The patients underwent (18)F-FDG PET/HRCT. The pulmonary imaging findings in the IPF patients were compared to the findings in a control population. Pulmonary uptake of (18)F-FDG (mean SUV) was quantified at sites of morphologically normal parenchyma on HRCT. SUVs were also corrected for tissue fraction (TF). The mean SUV in IPF patients was compared with that in 25 controls (patients with lymphoma in remission or suspected paraneoplastic syndrome with normal PET/CT appearances). RESULTS The pulmonary SUV (mean ± SD) uncorrected for TF in the controls was 0.48 ± 0.14 and 0.78 ± 0.24 taken from normal lung regions in IPF patients (p < 0.001). The TF-corrected mean SUV in the controls was 2.24 ± 0.29 and 3.24 ± 0.84 in IPF patients (p < 0.001). CONCLUSION IPF patients have increased pulmonary uptake of (18)F-FDG on PET in areas of lung with a normal morphological appearance on HRCT. This may have implications for determining disease mechanisms and treatment monitoring.
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Affiliation(s)
- Thida Win
- Respiratory Medicine, Lister Hospital, Stevenage, UK
| | - Benjamin A. Thomas
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Tryphon Lambrou
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Brian F. Hutton
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | | | - Joanna C. Porter
- Centre for Respiratory Diseases, University College Hospital, University College London, Euston Rd, London, UK
| | - Toby M. Maher
- Interstitial Lung Disease Unit, Royal Brompton Hospital, London, UK
| | - Raymondo Endozo
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Robert I. Shortman
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Asim Afaq
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Pauline Lukey
- Fibrosis DPU, Research and Development, GSK, Stevenage, UK
| | - Peter J. Ell
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
| | - Ashley M. Groves
- Institute of Nuclear Medicine, University College Hospital, University College London, 5th Floor, 235 Euston Road, London, NW1 2BU UK
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Maniwa T, Endo M, Isaka M, Nakagawa K, Ohde Y, Okumura T, Kondo H. Acute exacerbation of interstitial lung disease with lung cancer after surgery: evaluation with 2-[18]-fluoro-2-deoxy-d-glucose positron emission tomography. Surg Today 2013; 44:494-8. [DOI: 10.1007/s00595-013-0711-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Accepted: 01/16/2013] [Indexed: 11/24/2022]
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Maher TM. The diagnosis of idiopathic pulmonary fibrosis and its complications. ACTA ACUST UNITED AC 2013; 2:1317-31. [PMID: 23496780 DOI: 10.1517/17530050802549484] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a devastating, progressive condition with a median survival of 2.8 - 4 years from diagnosis. Clinicians confronted with a patient with fibrosing lung disease need to be reliably able to distinguish IPF from other diffuse parenchymal lung diseases. Furthermore, they need to be able to gauge prognosis, evaluate timing of interventions including referral for transplant, assess reliably the effectiveness of treatment and be able to detect rapidly the development of disease complications. OBJECTIVE/METHOD This paper provides an overview of currently available diagnostic tests for IPF and its complications and evaluates the possible future role of candidate biomarkers in the diagnosis and assessment of patients with IPF. A literature search was performed for papers evaluating diagnostic tests in the diagnosis of IPF and its complications. CONCLUSION Computed tomography combined with clinical data is sufficient for diagnosing IPF in approximately two-thirds of patients with the condition. For the remaining patients, histological assessment is important in achieving a precise diagnosis. Serial measurements of carbon monoxide diffusing capacity and forced vital capacity provide the best prognostic indicator in IPF. Potential biomarkers for diagnosing IPF include KL-6, MMP1 and MMP7. Brain naturetic peptide shows promise as a non-invasive screening tool for the diagnosis of IPF-associated pulmonary hypertension.
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Affiliation(s)
- Toby M Maher
- Centre for Respiratory Research, University College London, Rayne Institute, 5 University Street, WC1E 6JJ, UK +0207 679 6975 ; +0207 679 6973 ;
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Nononcological Applications of Positron Emission Tomography for Evaluation of the Thorax. J Thorac Imaging 2013; 28:25-39. [DOI: 10.1097/rti.0b013e31827882a9] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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24
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Mostard RLM, Verschakelen JA, van Kroonenburgh MJPG, Nelemans PJ, Wijnen PAHM, Vöö S, Drent M. Severity of pulmonary involvement and (18)F-FDG PET activity in sarcoidosis. Respir Med 2012; 107:439-47. [PMID: 23261309 DOI: 10.1016/j.rmed.2012.11.011] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2012] [Revised: 11/19/2012] [Accepted: 11/21/2012] [Indexed: 10/27/2022]
Abstract
BACKGROUND Assessing inflammatory activity is useful in the management of persistent symptomatic sarcoidosis patients. (18)F-FDG PET (PET) has been shown to be a sensitive technique to assess inflammatory activity in sarcoidosis. The aim of this study was to evaluate whether the severity of pulmonary involvement is associated with PET activity in persistent symptomatic sarcoidosis patients. METHODS Over a 5-year period, relevant clinical data including laboratory and lung function test results were gathered from the medical records of 95 sarcoidosis patients with persistent disabling symptoms who underwent both a PET and HRCT. HRCT scans were classified using a semiquantitative scoring system and PET findings as positive or negative, respectively. RESULTS PET was positive in 77/95 patients, of whom 56 demonstrated pulmonary PET-positivity. HRCT scores were high (7.1 ± 3.6) in patients with positive pulmonary PET findings (n = 56) compared to patients with negative pulmonary PET findings (n = 39; 3.0 ± 2.9; p < 0.001). DLCO (65 ± 20% predicted) and FVC (85 ± 24% predicted) were low in patients with pulmonary PET-positivity versus those with negative pulmonary PET findings (79 ± 16% predicted; p = 0.001 and 96 ± 22% predicted; p = 0.044, respectively). Interestingly, out of the 26 patients with fibrotic changes, 22 (85%) had positive pulmonary PET findings, of whom 18/22 (82%) showed extrathoracic PET-positive lesions and 16/22 (73%) showed signs of serological inflammation. CONCLUSIONS The severity of the pulmonary involvement, assessed by HRCT features and lung function parameters, appeared to be associated with PET activity in sarcoidosis. The majority of patients with fibrotic changes demonstrated inflammatory activity at pulmonary and extrathoracic sites.
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Affiliation(s)
- Rémy L M Mostard
- Department of Respiratory Medicine, Atrium Medical Centre, Heerlen, The Netherlands
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Win T, Screaton NJ, Porter J, Endozo R, Wild D, Kayani I, Dickson J, Shortman RI, Reubi JC, Ell PJ, Groves AM. Novel Positron Emission Tomography/Computed Tomography of Diffuse Parenchymal Lung Disease Combining a Labeled Somatostatin Receptor Analogue and 2-Deoxy-2 [18F] Fluoro-D-Glucose. Mol Imaging 2012. [DOI: 10.2310/7290.2011.00030] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
We prospectively investigated the potential of positron emission tomography (PET) using the somatostatin receptor (SSTR) analogue 68Ga-DOTATATE and 2-deoxy-2[18F]fluoro-D-glucose (18F-FDG) in diffuse parenchymal lung disease (DPLD). Twenty-six patients (mean age 68.9 ± 11.0 years) with DPLD were recruited for 68Ga-DOTATATE and 18F-FDG combined PET/high-resolution computed tomography (HRCT) studies. Ten patients had idiopathic pulmonary fibrosis (IPF), 12 patients had nonspecific interstitial pneumonia (NSIP), and 4 patients had other forms of DPLD. Using PET, the pulmonary tracer uptake (maximum standardized uptake value [SUVmax]) was calculated. The distribution of PET tracer was compared to the distribution of lung parenchymal changes on HRCT. All patients demonstrated increased pulmonary PET signal with 68Ga-DOTATATE and 18F-FDG. The distribution of parenchymal uptake was similar, with both tracers corresponding to the distribution of HRCT changes. The mean SUVmax was 2.2 ± 0.7 for 68Ga-DOTATATE and 2.8 ± 1.0 ( t-test, p = .018) for 18F-FDG. The mean 68Ga-DOTATATE SUVmax in IPF patients was 2.5 ± 0.9, whereas it was 2.0 ± 0.7 ( p = .235) in NSIP patients. The correlation between 68Ga-DOTATATE SUVmax and gas transfer (transfer factor of the lung for carbon monoxide [TLCO]) was r = .34 ( p = .127) and r = .49 ( p = .028) between 18F-FDG SUVmax and TLCO. We provide noninvasive in vivo evidence in humans showing that SSTRs may be detected in the lungs of patients with DPLD in a similar distribution to sites of increased uptake of 18F-FDG on PET.
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Affiliation(s)
- Thida Win
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Nicholas J. Screaton
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Joanna Porter
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Raymondo Endozo
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Damian Wild
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Irfan Kayani
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - John Dickson
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Robert I. Shortman
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Jean C. Reubi
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Peter J. Ell
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
| | - Ashley M. Groves
- From the Department of Respiratory Medicine, Lister Hospital, Stevenage, UK; Department of Radiology, Papworth Hospital, Cambridge, UK; Department of Respiratory Medicine and Institute of Nuclear Medicine, University College London/University College London Hospital, London, UK; Department of Nuclear Medicine, University Hospital Freiburg, Freiburg, Germany; and Division of Cell Biology and Experimental Cancer Research, University of Bern, Bern, Switzerland
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18F-Fluorodeoxyglucose positron emission tomography pulmonary imaging in idiopathic pulmonary fibrosis is reproducible: implications for future clinical trials. Eur J Nucl Med Mol Imaging 2011; 39:521-8. [DOI: 10.1007/s00259-011-1986-7] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 10/21/2011] [Indexed: 10/15/2022]
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Behnam Azad B, Ashique R, Labiris NR, Chirakal R. Temperature effects on the stereospecificity of nucleophilic fluorination: formation of trans-[18F]4-fluoro-l-proline during the synthesis of cis-[18F]4-fluoro-l-proline. J Labelled Comp Radiopharm 2011. [DOI: 10.1002/jlcr.1947] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
| | - Rezwan Ashique
- Department of Nuclear Medicine; Hamilton Health Sciences; MUMC Site; Hamilton; ON; L8N 3Z5; Canada
| | - N. Renée Labiris
- Department of Medicine; McMaster University; Hamilton; ON; L8S 4K1; Canada
| | - Raman Chirakal
- Department of Nuclear Medicine; Hamilton Health Sciences; MUMC Site; Hamilton; ON; L8N 3Z5; Canada
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Takahashi R, Hirata H, Tachibana I, Shimosegawa E, Inoue A, Nagatomo I, Takeda Y, Kida H, Goya S, Kijima T, Yoshida M, Kumagai T, Kumanogoh A, Okumura M, Hatazawa J, Kawase I. Early [18F]fluorodeoxyglucose positron emission tomography at two days of gefitinib treatment predicts clinical outcome in patients with adenocarcinoma of the lung. Clin Cancer Res 2011; 18:220-8. [PMID: 22019513 DOI: 10.1158/1078-0432.ccr-11-0868] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE Positron emission tomography (PET) with [(18)F]fluorodeoxyglucose (FDG) is increasingly used in early assessment of tumor response after chemotherapy. We investigated whether a change in [(18)F]FDG uptake at 2 days of gefitinib treatment predicts outcome in patients with lung adenocarcinoma. EXPERIMENTAL DESIGN Twenty patients were enrolled. [(18)F]FDG-PET/computed tomographic (CT) scan was carried out before and 2 days after gefitinib treatment. Maximum standardized uptake values (SUV) were measured, and post-gefitinib percentage changes in SUV were calculated. Early metabolic response (SUV decline < -25%) was compared with morphologic response evaluated by CT scan and with progression-free survival (PFS). RESULTS At 2 days of gefitinib treatment, 10 patients (50%) showed metabolic response, 8 had metabolic stable disease, and 2 had progressive metabolic disease. Percentage changes of SUV at 2 days were correlated with those of tumor size in CT at 1 month (R(2) = 0.496; P = 0.0008). EGFR gene was assessable in 15 patients, and of 12 patients with EGFR mutations, 8 showed metabolic response at 2 days and 6 showed morphologic response at 1 month. None of 3 patients with wild-type EGFR showed metabolic or morphologic response. Metabolic response at 2 days was not statistically associated with PFS (P = 0.095), but when a cutoff value of -20% in SUV decline was used, metabolic responders had longer PFS (P < 0.0001). CONCLUSION Early assessment of [(18)F]FDG tumor uptake with PET at 2 days of gefitinib treatment could be useful to predict clinical outcome earlier than conventional CT evaluation in patients with lung adenocarcinoma.
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Affiliation(s)
- Ryo Takahashi
- Department of Respiratory Medicine, Allergy and Rheumatic Diseases, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
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Abstract
The role of fluoro-2-deoxyglucose (FDG) positron emission tomography (PET) in the diagnosis, staging, and monitoring of neoplastic conditions is well established. The clinical utility of PET/CT has now expanded to the diagnosis of autoimmune, inflammatory, infectious, as well as non-neoplastic conditions, such as the vasculitides, atherosclerosis, and granulomatous conditions, including sarcoidosis and inflammatory bowel disease, in addition to a variety of neurologic disorders. The availability of new PET radiotracers is expected to expand PET/CT applications to a variety of other clinical domains. New radioligands for studying inflammation and neurodegenerative processes are under development. Here, we discuss the evolving potential role of PET imaging for the evaluation and monitoring of miscellaneous conditions, including osteoarthritis, interstitial lung disease, vascular thromboses, and osteoporosis.
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Affiliation(s)
- Mandana Hashefi
- Division of Rheumatology, George Washington University, Washington, District of Columbia, USA.
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Lambrou T, Groves AM, Erlandsson K, Screaton N, Endozo R, Win T, Porter JC, Hutton BF. The importance of correction for tissue fraction effects in lung PET: preliminary findings. Eur J Nucl Med Mol Imaging 2011; 38:2238-46. [PMID: 21874321 DOI: 10.1007/s00259-011-1906-x] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Accepted: 08/04/2011] [Indexed: 12/18/2022]
Abstract
PURPOSE It has recently been recognized that PET/CT may play a role in diffuse parenchymal lung disease. However, interpretation can be confounded due to the variability in lung density both within and between individuals. To address this issue a novel correction method is proposed. METHODS A CT scan acquired during shallow breathing is registered to a PET study and smoothed so as to match the PET resolution. This is used to derive voxel-based tissue fraction correction factors for the individual. The method was evaluated in a lung phantom study in which the lung was simulated by a Styrofoam/water mixture. The method was further evaluated using (18)F-FDG in 12 subjects free from pulmonary disease where ranges before and after correction were considered. RESULTS Correction resulted in similar activity concentrations for the lung and background regions, consistent with the experimental phantom set-up. Correction resulted in reduced inter- and intrasubject variability in the estimated SUV. The possible application of the method was further demonstrated in five subjects with interstitial lung changes where increased SUV was demonstrated. Single study pre- and post-treatment studies were also analysed to further illustrate the utility of the method. CONCLUSION The proposed tissue fraction correction method is a promising technique to account for variability of density in interpreting lung PET studies.
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Affiliation(s)
- Tryphon Lambrou
- Institute of Nuclear Medicine, University College London, 235 Euston Road (T5), London NW1 2BU, UK
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Lynch JP, Fishbein MC, Saggar R, Zisman DA, Belperio JA. Idiopathic pulmonary fibrosis. Expert Rev Respir Med 2010; 1:377-89. [PMID: 20477177 DOI: 10.1586/17476348.1.3.377] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Idiopathic pulmonary fibrosis (IPF; also known as cryptogenic fibrosing alveolitis) is a distinctive type of chronic fibrosing interstitial pneumonia of unknown cause associated with the histological pattern usual interstitial pneumonia (UIP). UIP is a distinct histological pattern observed in IPF but may also be found in other etiologies. The diagnosis of UIP can be established by surgical lung biopsy or by high-resolution thin-section CT scans (provided the radiographic features are classical). Historically, patients labeled as 'IPF' encompassed a group of disorders, including UIP, as well as other idiopathic interstitial pneumonias, which differ from UIP in prognosis and responsiveness to therapy. The term IPF should be restricted to patients with idiopathic UIP. The inciting cause(s) and pathogenesis of IPF have not been elucidated but alveolar epithelial cell injury and dysregulation or altered phenotypic expression of fibroblasts are key elements. Inflammatory cells may play minor roles in initiating or propagating the fibrotic process. The prognosis of idiopathic UIP is poor. Mean survival following diagnosis approximates at 3 years. Current medical therapies are of unproven value. Lung transplantation is a viable option for patients failing medical therapy.
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Affiliation(s)
- Joseph P Lynch
- The David Geffen School of Medicine at UCLA, Division of Pulmonary, Critical Care Medicine, and Hospitalists, 10833 Le Conte Avenue, Room CHS 37-131, Los Angeles, CA 90095, USA.
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Kalkanis D, Stefanovic A, Paes F, Escalon MP, Serafini A, Lossos IS. [18F]-fluorodeoxyglucose positron emission tomography combined with computed tomography detection of asymptomatic late pulmonary toxicity in patients with non-Hodgkin lymphoma treated with rituximab-containing chemotherapy. Leuk Lymphoma 2009; 50:904-11. [DOI: 10.1080/10428190902919200] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Krajicek BJ, Ryu JH, Hartman TE, Lowe VJ, Vassallo R. Abnormal Fluorodeoxyglucose PET in Pulmonary Langerhans Cell Histiocytosis. Chest 2009; 135:1542-1549. [DOI: 10.1378/chest.08-1899] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Inoue K, Okada K, Taki Y, Goto R, Kinomura S, Fukuda H. 18FDG uptake associated with CT density on PET/CT in lungs with and without chronic interstitial lung diseases. Ann Nucl Med 2009; 23:277-81. [DOI: 10.1007/s12149-009-0234-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2008] [Accepted: 12/07/2008] [Indexed: 02/06/2023]
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Groves AM, Win T, Screaton NJ, Berovic M, Endozo R, Booth H, Kayani I, Menezes LJ, Dickson JC, Ell PJ. Idiopathic pulmonary fibrosis and diffuse parenchymal lung disease: implications from initial experience with 18F-FDG PET/CT. J Nucl Med 2009; 50:538-45. [PMID: 19289428 DOI: 10.2967/jnumed.108.057901] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
UNLABELLED The purpose of this study was to evaluate integrated (18)F-FDG PET/CT in patients with idiopathic pulmonary fibrosis (IPF) and diffuse parenchymal lung disease (DPLD). METHODS Thirty-six consecutive patients (31 men and 5 women; mean age +/- SD, 68.7 +/- 9.4 y) with IPF (n = 18) or other forms of DPLD (n = 18) were recruited for PET/CT and high-resolution CT (HRCT), acquired on the same instrument. The maximal pulmonary (18)F-FDG metabolism was measured as a standardized uptake value (SUV(max)). At this site, the predominant lung parenchyma HRCT pattern was defined for each patient: ground-glass or reticulation/honeycombing. Patients underwent a global health assessment and pulmonary function tests. RESULTS Raised pulmonary (18)F-FDG metabolism in 36 of 36 patients was observed. The parenchymal pattern on HRCT at the site of maximal (18)F-FDG metabolism was predominantly ground-glass (7/36), reticulation/honeycombing (26/36), and mixed (3/36). The mean SUV(max) in patients with ground-glass and mixed patterns was 2.0 +/- 0.4, and in reticulation/honeycombing it was 3.0 +/- 1.0 (Mann-Whitney U test, P = 0.007). The mean SUV(max) in patients with IPF was 2.9 +/- 1.1, and in other DPLD it was 2.7 +/- 0.9 (Mann-Whitney U test, P = 0.862). The mean mediastinal lymph node SUV(max) (2.7 +/- 1.3) correlated with pulmonary SUV(max) (r = 0.63, P < 0.001). Pulmonary (18)F-FDG uptake correlated with the global health score (r = 0.50, P = 0.004), forced vital capacity (r = 0.41, P = 0.014), and transfer factor (r = 0.37, P = 0.042). CONCLUSION Increased pulmonary (18)F-FDG metabolism in all patients with IPF and other forms of DPLD was observed. Pulmonary (18)F-FDG uptake predicts measurements of health and lung physiology in these patients. (18)F-FDG metabolism was higher when the site of maximal uptake corresponded to areas of reticulation/honeycomb on HRCT than to those with ground-glass patterns.
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Affiliation(s)
- Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, United Kingdom
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Dual-time-point 18F-FDG PET imaging for diagnosis of disease type and disease activity in patients with idiopathic interstitial pneumonia. Eur J Nucl Med Mol Imaging 2009; 36:1121-30. [DOI: 10.1007/s00259-009-1069-1] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2008] [Accepted: 01/07/2009] [Indexed: 12/17/2022]
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Drug-induced pneumonitis detected earlier by 18F-FDG-PET than by high-resolution CT: a case report with non-Hodgkin's lymphoma. Ann Nucl Med 2008; 22:719-22. [PMID: 18982476 DOI: 10.1007/s12149-008-0183-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2007] [Accepted: 01/25/2008] [Indexed: 11/27/2022]
Abstract
Drug-induced pneumonitis is a serious and an unpredictable side effect of chemotherapy in patients with malignant lymphoma. We present the case of a 51-year-old man who developed drug-induced pneumonitis during chemotherapy for non-Hodgkin's lymphoma in which pneumonitis was detected earlier by 18F-fluorodeoxyglucose positron emission tomography (18F-FDG-PET) than by high-resolution computed tomography (HRCT). After five courses of chemotherapy, 18F-FDG-PET was performed for assessing residual lesions, and diffuse lung uptake was incidentally observed. No symptoms were present, and HRCT performed immediately following PET revealed no abnormalities. Mild dyspnea appeared 3 days after PET, and additional HRCT revealed patchy ground-glass opacities disseminated with the appearance of interlobular septum thickening. Drug-induced pneumonitis was finally diagnosed, and treatment was initiated. 18F-FDG-PET can be an imaging modality for detecting drug-induced pneumonitis at an extremely early stage in which HRCT is incapable of revealing any abnormal changes.
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Morikawa M, Demura Y, Mizuno S, Ameshima S, Ishizaki T, Okazawa H. FDG positron emission tomography imaging of drug-induced pneumonitis. Ann Nucl Med 2008; 22:335-8. [PMID: 18535887 DOI: 10.1007/s12149-007-0109-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2007] [Accepted: 12/07/2007] [Indexed: 12/16/2022]
Abstract
Several studies have reported the findings of fluorine-18-labeled fluoro-2-deoxy-D: -glucose positron emission tomography (FDG-PET) in benign lung disease with diffuse pulmonary injury; however, the characteristics and effectiveness of FDG-PET imaging for interstitial pneumonitis have not been substantiated. We report two cases of drug-induced pneumonitis in two patients treated for breast cancer who were diagnosed by FDG-PET examination. Both the cases showed diffuse interstitial infiltration in the bilateral lungs on computed tomography, but the degree of FDG accumulation was different. It is probable that the degree of FDG accumulation reflected the activity of the drug-induced pneumonitis. The present cases show very interesting FDG-PET imaging findings of diffuse lung disease.
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Affiliation(s)
- Miwa Morikawa
- Department of Respiratory Medicine, University of Fukui, 23-3 Matsuoka-Shimoaizuki, Eiheiji-cho, Yoshida-gun, Fukui, Japan.
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NUSAIR S, RUBINSTEIN R, FREEDMAN NM, AMIR G, BOGOT NR, IZHAR U, BREUER R. Positron emission tomography in interstitial lung disease. Respirology 2007; 12:843-7. [DOI: 10.1111/j.1440-1843.2007.01143.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Meyer GS, Hales CA, Amrein PC, Sharma A, Kradin RL. Case records of the Massachusetts General Hospital. Case 26-2007 - a 61-year-old man with recurrent fevers. N Engl J Med 2007; 357:807-16. [PMID: 17715414 DOI: 10.1056/nejmcpc079020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
MESH Headings
- Antineoplastic Combined Chemotherapy Protocols/therapeutic use
- Cyclophosphamide/therapeutic use
- Diagnosis, Differential
- Doxorubicin/therapeutic use
- Duodenum/pathology
- Fever/etiology
- Fluorodeoxyglucose F18
- Humans
- Lung/diagnostic imaging
- Lung/pathology
- Lung Neoplasms/complications
- Lung Neoplasms/diagnosis
- Lung Neoplasms/drug therapy
- Lymphoma, B-Cell/complications
- Lymphoma, B-Cell/diagnosis
- Lymphoma, B-Cell/drug therapy
- Lymphoma, Large B-Cell, Diffuse/complications
- Lymphoma, Large B-Cell, Diffuse/diagnosis
- Lymphoma, Large B-Cell, Diffuse/drug therapy
- Male
- Middle Aged
- Positron-Emission Tomography
- Prednisone/therapeutic use
- Radiography
- Recurrence
- Renal Insufficiency/etiology
- Salvage Therapy
- Vascular Neoplasms/complications
- Vascular Neoplasms/diagnosis
- Vascular Neoplasms/drug therapy
- Vincristine/therapeutic use
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Affiliation(s)
- Gregg S Meyer
- Department of Medicine, Massachusetts General Hospital, USA
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42
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Metser U, Even-Sapir E. Increased (18)F-fluorodeoxyglucose uptake in benign, nonphysiologic lesions found on whole-body positron emission tomography/computed tomography (PET/CT): accumulated data from four years of experience with PET/CT. Semin Nucl Med 2007; 37:206-22. [PMID: 17418153 DOI: 10.1053/j.semnuclmed.2007.01.001] [Citation(s) in RCA: 165] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
The use of (18)F-fluorodeoxyglucose positron emission tomography ((18)F-FDG-PET) in the field of oncology is rapidly evolving; however, (18)F-FDG is not tumor specific. Aside from physiological uptake (18)F-FDG also may accumulate in benign processes. Knowledge of these (18)F-FDG-avid nonmalignant lesions is essential for accurate PET interpretation in oncologic patients to avoid a false-positive interpretation. Through the systematic review of the reports of PET/computed tomography (CT) studies performed in oncologic patients during a 6-month period, we found benign nonphysiological uptake of (18)F-FDG in more than 25% of studies. In half of these, (18)F-FDG uptake was moderate or marked in intensity, similar to that of malignant sites. A total of 73% of benign lesions were inflammatory in nature, with post-traumatic bone and soft-tissue abnormalities (including iatrogenic injury) and benign tumors accounting for the remainder. The differentiation of benign from malignant uptake of (18)F-FDG on PET alone may be particularly challenging as a result of the low anatomical resolution of PET and paucity of anatomical landmarks. Fusion imaging, namely PET/CT, has been shown to improve not only the sensitivity of PET interpretation but also its specificity. Aside from better anatomical localization of lesions on PET/CT, morphological characterization of lesions on CT often may improve the diagnostic accuracy of nonspecific (18)F-FDG uptake. Correlation with CT on fused PET/CT data may obviate the need for further evaluation or biopsy in more than one-third of scintigraphic equivocal lesions. Familiarity with (18)F-FDG-avid nonmalignant lesions also may extend the use of (18)F-FDG-PET imaging beyond the field of oncology. We have tabulated our experience with benign entities associated with increased (18)F-FDG uptake on whole-body PET/CT from 12,000 whole-body (18)F-FDG-PET/CT studies performed during a 4-year period.
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Affiliation(s)
- Ur Metser
- Department of Nuclear Medicine, Tel-Aviv Sourasky Medical Center, Tel-Aviv, Israel
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Raynaud FR, Huglo D, Steinling M. La tomographie d'émission de positons en médecine interne : applications actuelles et perspectives d'avenir. Rev Med Interne 2006; 27:932-45. [PMID: 16870308 DOI: 10.1016/j.revmed.2006.06.012] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2006] [Accepted: 06/07/2006] [Indexed: 01/18/2023]
Abstract
PURPOSE Fluorodeoxyglucose positron emission tomography (FDG-PET) is a promising imaging technique that has already proven effective in modifying patient care in oncology. Fluorodeoxyglucose still remains the main radiopharmaceutical agent routinely used for PET imaging. A growing interest has recently lead to broaden PET research on benign disorders. The field of inflammatory or immune diseases and globally the field of internal medicine could also be impacted by FDG-PET. MAIN POINTS Great vessels vasculitides and fever of unknown origin have both been studied by several teams and could become indications for PET. In addition, current indications now extend to paraneoplastic syndromes. It is thus possible to foresee that the clinical applications for PET will continue to expand in these patients. PERSPECTIVES AND PROJECTS In the future, inflammatory arthritis, chronic inflammatory bowel diseases, systemic erythematous lupus, histiocytosis, or pulmonary and retroperitoneal fibrosis might benefit from PET even if, available data remains scarce to this day. Although PET will probably alter the landscape of patient management in internal medicine in the near future, additional clinical research is still needed to ascertain the exact role of PET.
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Affiliation(s)
- F-R Raynaud
- Service de médecine nucléaire et d'imagerie fonctionnelle, hôpital Claude-Huriez, CHRU de Lille, 59037 Lille cedex, France.
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