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Bayat S, Wild J, Winkler T. Lung functional imaging. Breathe (Sheff) 2023; 19:220272. [PMID: 38020338 PMCID: PMC10644108 DOI: 10.1183/20734735.0272-2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Accepted: 10/08/2023] [Indexed: 12/01/2023] Open
Abstract
Pulmonary functional imaging modalities such as computed tomography, magnetic resonance imaging and nuclear imaging can quantitatively assess regional lung functional parameters and their distributions. These include ventilation, perfusion, gas exchange at the microvascular level and biomechanical properties, among other variables. This review describes the rationale, strengths and limitations of the various imaging modalities employed for lung functional imaging. It also aims to explain some of the most commonly measured parameters of regional lung function. A brief review of evidence on the role and utility of lung functional imaging in early diagnosis, accurate lung functional characterisation, disease phenotyping and advancing the understanding of disease mechanisms in major respiratory disorders is provided.
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Affiliation(s)
- Sam Bayat
- Department of Pulmonology and Physiology, CHU Grenoble Alpes, Grenoble, France
- Univ. Grenoble Alpes, STROBE Laboratory, INSERM UA07, Grenoble, France
| | - Jim Wild
- POLARIS, Imaging Group, Department of Infection Immunity and Cardiovascular Disease, University of Sheffield, Sheffield, UK
- Insigneo Institute, University of Sheffield, Sheffield, UK
| | - Tilo Winkler
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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Song X, Zhou Y, Zhou M, Huang Y, Li Z, You Q, Lu N, Guo Q. Wogonin influences vascular permeability via Wnt/β-catenin pathway. Mol Carcinog 2013; 54:501-12. [DOI: 10.1002/mc.22093] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 07/08/2013] [Indexed: 12/18/2022]
Affiliation(s)
- Xiuming Song
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Yuxin Zhou
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Mi Zhou
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Yujie Huang
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Zhiyu Li
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Qidong You
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Na Lu
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
| | - Qinglong Guo
- State Key Laboratory of Natural Medicines; Jiangsu Key Laboratory of Carcinogenesis and Intervention, China Pharmaceutical University; Nanjing People's Republic of China
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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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Banerjee SR, Pomper MG. Clinical applications of Gallium-68. Appl Radiat Isot 2013; 76:2-13. [PMID: 23522791 DOI: 10.1016/j.apradiso.2013.01.039] [Citation(s) in RCA: 161] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2012] [Accepted: 01/10/2013] [Indexed: 11/16/2022]
Abstract
Gallium-68 is a positron-emitting radioisotope that is produced from a (68)Ge/(68)Ga generator. As such it is conveniently used, decoupling radiopharmacies from the need for a cyclotron on site. Gallium-68-labeled peptides have been recognized as a new class of radiopharmaceuticals showing fast target localization and blood clearance. (68)Ga-DOTATOC, (8)Ga-DOTATATE, (68)Ga-DOTANOC, are the most prominent radiopharmaceuticals currently in use for imaging and differentiating lesions of various somatostatin receptor subtypes, overexpressed in many neuroendocrine tumors. There has been a tremendous increase in the number of clinical studies with (68)Ga over the past few years around the world, including within the United States. An estimated ∼10,000 scans are being performed yearly in Europe at about 100 centers utilizing (68)Ga-labeled somatostatin analogs within clinical trials. Two academic sites within the US have also begun to undertake human studies. This review will focus on the clinical experience of selected, well-established and recently applied (68)Ga-labeled imaging agents used in nuclear medicine.
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Affiliation(s)
- Sangeeta Ray Banerjee
- Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD 21231, USA
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Abstract
The continued progression of chronic lung disease despite current treatment options has led to the increasing evaluation of molecular imaging tools for diagnosis, treatment planning, drug discovery, and therapy monitoring. Concurrently the development of multimodality positron emission tomography (PET) / computed tomography (CT), single-photon emission computed tomography (SPECT)/CT, and magnetic resonance imaging (MRI)/PET scanners has opened the potential for more sophisticated imaging biomarker probes. Here we review the potential uses of multimodality imaging tools, the established uses of molecular imaging in nononcologic lung pathophysiology and drug discovery, and some of the technical challenges in multimodality molecular imaging of the lung.
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Affiliation(s)
- Delphine L Chen
- Division of Nuclear Medicine Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri, USA
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Sandanaraj BS, Gremlich HU, Kneuer R, Dawson J, Wacha S. Fluorescent Nanoprobes as a Biomarker for Increased Vascular Permeability: Implications in Diagnosis and Treatment of Cancer and Inflammation. Bioconjug Chem 2009; 21:93-101. [DOI: 10.1021/bc900311h] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- Britto S. Sandanaraj
- Global Imaging Group and Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Hans-Ulrich Gremlich
- Global Imaging Group and Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Rainer Kneuer
- Global Imaging Group and Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Janet Dawson
- Global Imaging Group and Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
| | - Stefan Wacha
- Global Imaging Group and Department of Autoimmunity, Transplantation and Inflammation, Novartis Institutes for Biomedical Research, Basel, Switzerland
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Zhang H, Lawson WE, Polosukhin VV, Pozzi A, Blackwell TS, Litingtung Y, Chiang C. Inhibitor of differentiation 1 promotes endothelial survival in a bleomycin model of lung injury in mice. THE AMERICAN JOURNAL OF PATHOLOGY 2007; 171:1113-26. [PMID: 17717145 PMCID: PMC1988863 DOI: 10.2353/ajpath.2007.070226] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
The Id family of genes encodes negative regulators of basic helix-loop-helix transcription factors and has been implicated in diverse cellular processes such as proliferation, apoptosis, differentiation, and migration. However, the specific role of Id1 in lung injury has not been investigated. Bleomycin has been widely used to generate animal models of acute lung injury and fibrogenesis. In this study we found that, on bleomycin challenge, Id1 expression was significantly up-regulated in the lungs, predominantly in endothelial cells, as revealed by double immunolabeling and quantitative flow cytometric analysis. Mice with Id1 loss-of-function (Id1(-/-)) displayed increased vascular permeability and endothelial apoptosis in the lungs after bleomycin-induced injury. Cultured Id1(-/-) lung microvascular endothelial cells also showed decreased survival when exposed to bleomycin. We detected a decrease in the level of Bcl-2, a primary anti-apoptotic protein, in Id1(-/-) endothelial cells, suggesting that down-regulated Bcl-2 may promote endothelial apoptosis in the lung. Therefore, we propose that Id1 plays a crucial role in promoting endothelial survival in the adult lung on injury. In addition, bleomycin-exposed Id1(-/-) mice showed increased lung collagen accumulation and fibrogenesis, suggesting that Id1 up-regulation in the lung may play a critical role in lung homeostasis.
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Affiliation(s)
- Huimin Zhang
- Department of Cell and Developmental Biology, Vanderbilt University Medical Center, 4114 MRB III, Nashville, TN 37232, USA
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Abstract
Positron emission tomography (PET) provides three-dimensional images of the distributions of radionuclides that have been inhaled or injected into the lungs. By using radionuclides with short half-lives, the radiation exposure of the subject can be kept small. By following the evolution of the distributions of radionuclides in gases or compounds that participate in lung function, information about such diverse lung functions as regional ventilation, perfusion, shunt, gas fraction, capillary permeability, inflammation, and gene expression can be inferred. Thus PET has the potential to provide information about the links between cellular function and whole lung function in vivo. In this paper, recent advancements in PET methodology and techniques and information about lung function that have been obtained with these techniques are reviewed.
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Affiliation(s)
- R Scott Harris
- Pulmonary and Critical Care Unit, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
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Meissner HH, Soo Hoo GW, Khonsary SA, Mandelkern M, Brown CV, Santiago SM. Idiopathic Pulmonary Fibrosis: Evaluation with Positron Emission Tomography. Respiration 2006; 73:197-202. [PMID: 16141712 DOI: 10.1159/000088062] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2004] [Accepted: 03/10/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND The pathogenesis of interstitial lung disease remains under investigation, but may be related to increased inflammatory or cellular activity. This activity may be detectable with physiologic imaging. OBJECTIVES We investigated the role of physiologic imaging using (18)F-2-fluoro-2-deoxy-D-glucose ((18)FDG)-positron emission tomography (PET) scans in idiopathic pulmonary fibrosis (IPF). METHODS Seven male patients with histologically confirmed IPF underwent (18)FDG-PET scans. Scans were analyzed qualitatively and interpreted as positive or negative. Patients also underwent pulmonary function tests and computed tomography (CT) scans. RESULTS The average total lung capacity was 71 +/- 22% predicted (mean +/- SD) and diffusing capacity for carbon monoxide was 44 +/- 14% predicted. All had changes consistent with IPF on chest CT and 2 patients had ground glass attenuation. Six of seven patients (86%) had a positive (18)FDG-PET scan. Changes in the (18)FDG-PET scan were seen in 1 patient corresponding to changes in clinical status. CONCLUSIONS Our findings suggest that (18)FDG-PET scans may be helpful in the evaluation of IPF. Increased activity suggests active disease and changes in response to therapy.
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Affiliation(s)
- Horst-Helmut Meissner
- Division of Pulmonary and Critical Care Medicine, VA Greater Los Angeles Healthcare System, UCLA School of Medicine, Calif. 90073, USA
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Anderson CJ, Welch MJ. Radiometal-labeled agents (non-technetium) for diagnostic imaging. Chem Rev 1999; 99:2219-34. [PMID: 11749480 DOI: 10.1021/cr980451q] [Citation(s) in RCA: 383] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C J Anderson
- Mallinckrodt Institute of Radiology, Washington University School of Medicine 510 S. Kingshighway, Campus Box 8225 St. Louis, Missouri 63110
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Nama V, Kozlowski JK, Hamvas A. Measurement of protein flux with positron emission tomography in neonates. Arch Dis Child Fetal Neonatal Ed 1999; 80:F26-9. [PMID: 10325807 PMCID: PMC1720875 DOI: 10.1136/fn.80.1.f26] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIM To determine whether abnormal transvascular protein flux can be measured with positron emission tomography (PET) in neonates with respiratory distress syndrome (RDS). METHODS Fourteen infants with normal gas exchange (non-RDS group) underwent one PET measurement and 12 infants with RDS (the RDS group) underwent two measurements of protein flux, as determined by the pulmonary transcapillary escape rate for 68Gallium labelled transferrin (PTCER). RESULTS The mean PTCER for the RDS infants (132 +/- 39 10(-4)/min) was significantly greater than that for infants without RDS (75 +/- 27 10(-4)/min). PTCER did not change between measurements in the infants with RDS, including five who received and responded to surfactant replacement between the two scans. CONCLUSIONS Increased transvascular flux of large molecular weight proteins complicates RDS in preterm infants. PET provides a tool with which to evaluate the processes that contribute to pulmonary dysfunction in neonates.
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Affiliation(s)
- V Nama
- Edward Mallinckrodt Department of Pediatrics, Washington University School of Medicine, St Louis, Missouri, USA
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Abstract
In many ways, the lung is an ideal organ for study with positron emission tomography (PET). First, structure-function relations are homogeneous over larger areas than in other organs (reducing problems associated with otherwise relatively poor spatial resolution and partial-volume averaging). Second, many physiologic and metabolic processes can be studied, including pulmonary blood flow, ventilation, vascular permeability, endothelial receptor and enzyme function, among others. A variety of radiotracers have been used to evaluate pulmonary blood flow with PET, including 68Ga- or 11C-albumin microspheres administered intravenously, H2 15O administered by i.v. infusion, and 13N-N2 administered by inhalation. Pulmonary ventilation has been evaluated with both 13N-N2 and 19Ne gas, also administered by inhalation. In general, the relative advantage of one approach over another depends on site-specific cyclotron capacity and experience, and on the nature and timing of concomitant studies with other positron-emitting radiopharmaceuticals. The various blood flow methods have been used primarily in studies of pulmonary gas exchange, in both experimental animals and in humans. Acute lung injury is usually defined by both an increase in extravascular water (pulmonary edema) and an increase in the permeability of the pulmonary endothelium to protein. Both processes can easily be evaluated with PET. Extravascular water is measured by a combination of scans with i.v. H2 15O and C15O. The latter is administered by inhalation to label the blood pool (to calculate intravascular water concentrations). Pulmonary vascular permeability has been evaluated with dynamic sequential imaging after either 68Ga-transferrin or 11C-methylalbumin infusions. The rate of uptake of either tracer into the pulmonary extravascular space is an index of "leakiness" of the pulmonary endothelium, and is quantified as the pulmonary transcapillary escape rate, or PTCER. PTCER appears to be a highly sensitive index of acute lung injury. Two receptor/ enzyme systems that have been evaluated include the beta-adrenergic receptor system (using 11CGP-12177 as the ligand) and angiotensin converting enzyme (using 18F-fluorocaptopril). In each case, the object is to measure Bmax, or the maximum binding-capacity for the ligand in question. Changes in Bmax can be used to infer changes in protein expression of the receptor or enzyme, or can be used to quantify adequacy of therapy with inhibitor drugs. Given the highly active nature of the pulmonary endothelium, it is likely that many other pulmonary receptor or enzyme systems can be studied in a similar fashion.
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Affiliation(s)
- D P Schuster
- Department of Internal Medicine, Washington University School of Medicine, St. Louis, MO 63110, USA
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Schuster DP, Markham J, Welch MJ. Positron emission tomography measurements of pulmonary vascular permeability with Ga-68 transferrin or C-11 methylalbumin. Crit Care Med 1998; 26:518-25. [PMID: 9504581 DOI: 10.1097/00003246-199803000-00026] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To compare estimates of pulmonary endothelial barrier integrity obtained using two different tracer proteins. DESIGN Measure the pulmonary transcapillary escape rate with gallium (Ga)-68 labeled transferrin (PTCER(tf)) and positron emission tomography (PET) imaging and compare the results to similar measurements obtained with C-11 labeled methylalbumin (PTCER(alb)). SETTING Laboratory investigation. SUBJECTS Mongrel dogs. INTERVENTIONS No intervention in one group of dogs (n = 3); oleic-acid induced lung injury in another set (n = 4). MEASUREMENTS AND MAIN RESULTS Although PTCER(tf) was consistently higher than PTCER(alb) (mean difference: 50 x 10(-4)/min), the overall correlation between the two methods, after normalizing for differences in regression slope and intercept among the individual dogs, was excellent (r2 = .67). CONCLUSION The data support the continued use of PET and Ga-68 transferrin as an appropriate means of evaluating and quantifying lung injury.
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Affiliation(s)
- D P Schuster
- Department of Internal Medicine, the Institute for Biomedical Computing, Washington University School of Medicine, St. Louis, MO 63110, USA
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Affiliation(s)
- D P Schuster
- Department of Internal Medicine, Washington University Medical School, St. Louis, MO, USA
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Schuster DP. What is the Mortality of ARDS? YEARBOOK OF INTENSIVE CARE AND EMERGENCY MEDICINE 1995. [DOI: 10.1007/978-3-642-79154-3_6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
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