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Deng X, Liu J, Zhou J, Shi Y, Song S, Chen J, Li Y, Yu B, Liang SH, Zhu X. Imaging Pulmonary Fibrosis and Treatment Efficacy In Vivo with Autotaxin-Specific PET Ligand [ 18F]ATX-1905. Mol Pharm 2024. [PMID: 39186477 DOI: 10.1021/acs.molpharmaceut.4c00571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/28/2024]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a fatal disease characterized by unpredictable progression and limited therapeutic options. Current diagnosis relies on high resolution computed tomography (HRCT), which may not adequately capture early signs of deterioration. The enzyme autotaxin (ATX) emerges as a prominently expressed extracellular secretory enzyme in the lungs of IPF patients. The objective of this study was to evaluate the effectiveness of 18F-labeled ATX-targeted tracer [18F]ATX-1905, in comparison with [18F]FDG, for early fibrosis diagnosis, disease evolution monitoring, and treatment efficacy assessment in bleomycin-induced pulmonary fibrosis (BPF) models. To assess treatment efficacy, mice were treated with two commonly used drugs for IPF, pirfenidone or nintedanib, from Day 9 to Day 23 postbleomycin administration. Lung tissue assessments encompassed inflammation severity via H&E staining, and Ashcroft scoring via Masson staining, alongside quantification of ATX expression through ELISA. Positron emission tomography (PET) imaging employing [18F]FDG and [18F]ATX-1905 tracked disease progression pre- and post-treatment. The extent of pulmonary fibrosis corresponded to changes in ATX expression levels in the BPF mouse model. Notably, [18F]ATX-1905 exhibited elevated uptake in BPF lungs during the progression of the disease, particularly evident at the early stage (Day 9). This uptake was inhibited by an ATX inhibitor, PF-8380, underscoring the specificity of the radiotracer. Conversely, [18F]FDG uptake, peaking at Day 15, decreased subsequently, likely reflective of diminished inflammation. A 2-week treatment regimen using either pirfenidone or nintedanib resulted in notable reductions of ATX expression levels and fibrosis degrees within lung tissues, based on ELISA and Masson staining, as evidenced by PET imaging with [18F]ATX-1905. [18F]FDG uptake also decreased following the treatment period. Additionally, PET/CT imaging extended to a nonhuman primate (NHP) BPF model. The uptake of [18F]ATX-1905 (SUVmax = 2.2) was significantly higher than that of [18F]FDG (SUVmax = 0.7) in fibrotic lung tissue. Using our novel ATX-specific radiotracer [18F]ATX-1905 and PET/CT imaging, we demonstrated excellent ability in early fibrosis detection, disease monitoring, and treatment assessment within lungs of the BPF mouse models. [18F]ATX-1905 displayed remarkable specificity for ATX expression and high sensitivity for ATX alterations, suggesting its potential for monitoring varying ATX expression in lungs of IPF patients.
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Affiliation(s)
- Xiaoyun Deng
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Junyi Liu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Jianyuan Zhou
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Yifan Shi
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Shuang Song
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Jiahui Chen
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia 30322, United States
| | - Yinlong Li
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia 30322, United States
| | - Bo Yu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
| | - Steven H Liang
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia 30322, United States
| | - Xiaohua Zhu
- Department of Nuclear Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Avenue, Wuhan 430030, China
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Ji H, Song X, Lv X, Shao F, Long Y, Song Y, Song W, Qiao P, Gai Y, Jiang D, Lan X. [ 68Ga]FAPI PET for Imaging and Treatment Monitoring in a Preclinical Model of Pulmonary Fibrosis: Comparison to [ 18F]FDG PET and CT. Pharmaceuticals (Basel) 2024; 17:726. [PMID: 38931393 PMCID: PMC11206307 DOI: 10.3390/ph17060726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 04/30/2024] [Accepted: 05/07/2024] [Indexed: 06/28/2024] Open
Abstract
PURPOSE This study aimed to evaluate the feasibility of using [68Ga]-fibroblast-activating protein inhibitor (FAPI) positron emission tomography (PET) imaging for diagnosing pulmonary fibrosis in a mouse model. We also examined its value in monitoring treatment response and compared it with traditional [18F]-fluorodeoxyglucose (FDG) PET and computed tomography (CT) imaging. METHODS A model of idiopathic pulmonary fibrosis was established using intratracheal injection of bleomycin (BLM, 2 mg/kg) into C57BL/6 male mice. For the treatment of IPF, a daily oral dose of 400 mg/kg/day of pirfenidone was administered from 9 to 28 days after the establishment of the model. Disease progression and treatment efficacy were assessed at different stages of the disease every week for four weeks using CT, [18F]FDG PET, and [68Ga]FAPI PET (baseline imaging performed at week 0). Mice were sacrificed and lung tissues were harvested for hematoxylin-eosin staining, picrosirius red staining, and immunohistochemical staining for glucose transporter 1 (GLUT1) and FAP. Expression levels of GLUT1 and FAP in pathological sections were quantified. Correlations between imaging parameters and pathological quantitative values were analyzed. RESULTS CT, [18F]FDG PET and [68Ga]FAPI PET revealed anatomical and functional changes in the lung that reflected progression of pulmonary fibrosis. In untreated mice with pulmonary fibrosis, lung uptake of [18F]FDG peaked on day 14, while [68Ga]FAPI uptake and mean lung density peaked on day 21. In mice treated with pirfenidone, mean lung density and lung uptake of both PET tracers decreased. Mean lung density, [18F]FDG uptake, and [68Ga]FAPI uptake correlated well with quantitative values of picrosirius red staining, GLUT1 expression, and FAP expression, respectively. Conclusions: Although traditional CT and [18F]FDG PET reflect anatomical and metabolic status in fibrotic lung, [68Ga]FAPI PET provides a means of evaluating fibrosis progression and monitoring treatment response.
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Affiliation(s)
- Hao Ji
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Xiangming Song
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Xiaoying Lv
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Fuqiang Shao
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yu Long
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yangmeihui Song
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Wenyu Song
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Pengxin Qiao
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
| | - Yongkang Gai
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan 430022, China
| | - Dawei Jiang
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan 430022, China
| | - Xiaoli Lan
- Department of Nuclear Medicine, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, China; (H.J.); (X.S.); (X.L.); (F.S.); (Y.L.); (Y.S.); (W.S.); (P.Q.); (Y.G.)
- Hubei Key Laboratory of Molecular Imaging, Wuhan 430022, China
- Key Laboratory of Biological Targeted Therapy of the Ministry of Education, Wuhan 430022, China
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Jablonski R. Lung Cancer and Lung Transplantation. CURRENT PULMONOLOGY REPORTS 2023. [DOI: 10.1007/s13665-023-00301-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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4
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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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Dhingra VK, Khan D, Kumar R, Basu S. Nonmalignant Thoracic Disorders: An Appraisal of Fluorodeoxyglucose and Non-fluorodeoxyglucose PET/Computed Tomography Applications. PET Clin 2022; 17:495-515. [PMID: 35717104 DOI: 10.1016/j.cpet.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PET/computed tomography (CT) with fluorodeoxyglucose and nonfluorodeoxyglucose PET tracers has established itself in the management of malignant disorders. Its role in the assessment of nonmalignant conditions, such as infectious and noninfectious inflammatory diseases and other benign conditions, has emerged independently and alongside its role being evaluated in malignancy and continues to evolve. It is evident that PET/CT has the potential to play a significant role in various nonmalignant disorders of the thorax. This review highlights current developments and areas where PET/CT has a potential to impact the clinical management of nonmalignant thoracic conditions with special focus on nonfluorodeoxyglucose tracers.
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Affiliation(s)
- Vandana Kumar Dhingra
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Dikhra Khan
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, Ansari Nagar East, New Delhi, Delhi 110029, India
| | - Rakesh Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Sri Aurobindo Marg, Ansari Nagar, Ansari Nagar East, New Delhi, Delhi 110029, India
| | - Sandip Basu
- Radiation Medicine Centre (B.A.R.C), Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, Maharashtra 400012, India; Homi Bhabha National Institute, 2nd floor, BARC Training School Complex, Anushaktinagar, Mumbai, Maharashtra 400094, India.
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6
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Benign lung diseases. Nucl Med Mol Imaging 2022. [DOI: 10.1016/b978-0-12-822960-6.00028-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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7
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Hobbs SB, Chung JH, Walker CM, Bang TJ, Carter BW, Christensen JD, Danoff SK, Kandathil A, Madan R, Moore WH, Shah SD, Kanne JP. ACR Appropriateness Criteria® Diffuse Lung Disease. J Am Coll Radiol 2021; 18:S320-S329. [PMID: 34794591 DOI: 10.1016/j.jacr.2021.08.008] [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: 08/19/2021] [Accepted: 08/26/2021] [Indexed: 11/28/2022]
Abstract
Diffuse lung disease, frequently referred to as interstitial lung disease, encompasses numerous disorders affecting the lung parenchyma. The potential etiologies of diffuse lung disease are broad with several hundred established clinical syndromes and pathologies currently identified. Imaging plays a critical role in diagnosis and follow-up of many of these diseases, although multidisciplinary discussion is the current standard for diagnosis of several DLDs. This document aims to establish guidelines for evaluation of diffuse lung diseases for 1) initial imaging of suspected diffuse lung disease, 2) initial imaging of suspected acute exacerbation or acute deterioration in cases of confirmed diffuse lung disease, and 3) clinically indicated routine follow-up of confirmed diffuse lung disease without acute deterioration. The American College of Radiology Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed annually by a multidisciplinary expert panel. The guideline development and revision include an extensive analysis of current medical literature from peer reviewed journals and the application of well-established methodologies (RAND/UCLA Appropriateness Method and Grading of Recommendations Assessment, Development, and Evaluation or GRADE) to rate the appropriateness of imaging and treatment procedures for specific clinical scenarios. In those instances where evidence is lacking or equivocal, expert opinion may supplement the available evidence to recommend imaging or treatment.
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Affiliation(s)
- Stephen B Hobbs
- Vice-Chair, Informatics and Integrated Clinical Operations and Division Chief, Cardiovascular and Thoracic Radiology, University of Kentucky, Lexington, Kentucky.
| | - Jonathan H Chung
- Panel Chair; and Vice-Chair of Quality, and Section Chief, Chest Imaging, Department of Radiology, University of Chicago, Chicago, Illinois
| | | | - Tami J Bang
- Co-Director, Cardiothoracic Imaging Fellowship Committee, University of Colorado School of Medicine, Anschutz Medical Campus, Aurora, Colorado; Co-Chair, membership committee, NASCI; and Membership committee, ad-hoc online content committee, STR
| | - Brett W Carter
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jared D Christensen
- Vice-Chair, Department of Radiology, Duke University Medical Center, Durham, North Carolina; and Chair, ACR Lungs-RADS
| | - Sonye K Danoff
- Johns Hopkins Medicine, Baltimore, Maryland; Board of Directors, American Thoracic Society; Senior Medical Advisor, Pulmonary Fibrosis Foundation; and Medical Advisory Board Member, The Myositis Association
| | | | - Rachna Madan
- Associate Fellowship Director, Division of Thoracic Imaging, Brigham & Women's Hospital, Boston, Massachusetts
| | - William H Moore
- Associate Chair, Clinical Informatics and Chief, Thoracic Imaging, New York University Langone Medical Center, New York, New York
| | - Sachin D Shah
- Associate Chief and Medical Information Officer, University of Chicago, Chicago, Illinois; and Primary care physician
| | - Jeffrey P Kanne
- Specialty Chair, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
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Nardocci C, Simon J, Kiss F, Györke T, Szántó P, Tárnoki ÁD, Tárnoki DL, Müller V, Maurovich-Horvat P. The role of imaging in the diagnosis and management of idiopathic pulmonary fibrosis. IMAGING 2021. [DOI: 10.1556/1647.2021.00048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
Idiopathic pulmonary fibrosis (IPF) is a chronic progressive disease lacking a definite etiology, characterized by the nonspecific symptoms of dyspnea and dry cough. Due to its poor prognosis, imaging techniques play an essential role in diagnosing and managing IPF. High resolution computed tomography (HRCT) has been shown to be the most sensitive modality for the diagnosis of pulmonary fibrosis. It is the primary imaging modality used for the assessment and follow-up of patients with IPF. Other not commonly used imaging methods are under research, such as ultrasound, magnetic resonance imaging and positron emission tomography-computed tomography are alternative imaging techniques. This literature review aims to provide a brief overview of the imaging of IPF-related alterations.
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Affiliation(s)
- Chiara Nardocci
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Judit Simon
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- 2 MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | - Fanni Kiss
- 3 Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Tamás Györke
- 3 Department of Nuclear Medicine, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Péter Szántó
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
| | - Ádám Domonkos Tárnoki
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- 4 National Institute of Oncology, Budapest, Hungary
| | - Dávid László Tárnoki
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- 4 National Institute of Oncology, Budapest, Hungary
| | - Veronika Müller
- 5 Department of Pulmonology, Semmelweis University, Budapest, Hungary
| | - Pál Maurovich-Horvat
- 1 Department of Radiology, Medical Imaging Centre, Semmelweis University, Budapest, Hungary
- 2 MTA-SE Cardiovascular Imaging Research Group, Heart and Vascular Center, Semmelweis University, Budapest, Hungary
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Liang J, Cao H, Liu Y, Ye B, Sun Y, Ke Y, He Y, Xu B, Lin J. The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease. Arthritis Res Ther 2021; 23:198. [PMID: 34301306 PMCID: PMC8298695 DOI: 10.1186/s13075-021-02578-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 07/09/2021] [Indexed: 12/03/2022] Open
Abstract
Background Interstitial lung disease (ILD) and its rapid progression (RP) are the main contributors to unfavourable outcomes of patients with idiopathic inflammatory myopathy (IIM). This study aimed to identify the clinical value of PET/CT scans in IIM-ILD patients and to construct a predictive model for RP-ILD. Methods Adult IIM-ILD patients who were hospitalized at four divisions of the First Affiliated Hospital, Zhejiang University School of Medicine (FAHZJU), from 1 January 2017 to 31 December 2020 were reviewed. PET/CT scans and other characteristics of patients who met the inclusion and exclusion criteria were collected and analysed. Results A total of 61 IIM-ILD patients were enrolled in this study. Twenty-one patients (34.4%) developed RP-ILD, and 24 patients (39.3%) died during follow-up. After false discovery rate (FDR) correction, the percent-predicted diffusing capacity of the lung for carbon monoxide (DLCO%, P = 0.014), bilateral lung mean standard uptake value (SUVmean, P = 0.014) and abnormal mediastinal lymph node (P = 0.045) were significantly different between the RP-ILD and non-RP-ILD groups. The subsequent univariate and multivariate logistic regression analyses verified our findings. A “DLM” model was established by including the above three values to predict RP-ILD with a cut-off value of ≥ 2 and an area under the curve (AUC) of 0.905. Higher bilateral lung SUVmean (P = 0.019) and spleen SUVmean (P = 0.011) were observed in IIM-ILD patients who died within 3 months, and a moderate correlation was recognized between the two values. Conclusions Elevated bilateral lung SUVmean, abnormal mediastinal lymph nodes and decreased DLCO% were significantly associated with RP-ILD in IIM-ILD patients. The “DLM” model was valuable in predicting RP-ILD and requires further validation. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02578-9.
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Affiliation(s)
- Junyu Liang
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Heng Cao
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Yinuo Liu
- PET Center, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Bingjue Ye
- Department of Respiratory Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Yiduo Sun
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Yini Ke
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Ye He
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Bei Xu
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China
| | - Jin Lin
- Department of Rheumatology, The First Affiliated Hospital, Zhejiang University School of Medicine, #79 Qingchun Road, Hangzhou, 310003, Zhejiang Province, People's Republic of China.
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Gefter WB, Lee KS, Schiebler ML, Parraga G, Seo JB, Ohno Y, Hatabu H. Pulmonary Functional Imaging: Part 2-State-of-the-Art Clinical Applications and Opportunities for Improved Patient Care. Radiology 2021; 299:524-538. [PMID: 33847518 DOI: 10.1148/radiol.2021204033] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pulmonary functional imaging may be defined as the regional quantification of lung function by using primarily CT, MRI, and nuclear medicine techniques. The distribution of pulmonary physiologic parameters, including ventilation, perfusion, gas exchange, and biomechanics, can be noninvasively mapped and measured throughout the lungs. This information is not accessible by using conventional pulmonary function tests, which measure total lung function without viewing the regional distribution. The latter is important because of the heterogeneous distribution of virtually all lung disorders. Moreover, techniques such as hyperpolarized xenon 129 and helium 3 MRI can probe lung physiologic structure and microstructure at the level of the alveolar-air and alveolar-red blood cell interface, which is well beyond the spatial resolution of other clinical methods. The opportunities, challenges, and current stage of clinical deployment of pulmonary functional imaging are reviewed, including applications to chronic obstructive pulmonary disease, asthma, interstitial lung disease, pulmonary embolism, and pulmonary hypertension. Among the challenges to the deployment of pulmonary functional imaging in routine clinical practice are the need for further validation, establishment of normal values, standardization of imaging acquisition and analysis, and evidence of patient outcomes benefit. When these challenges are addressed, it is anticipated that pulmonary functional imaging will have an expanding role in the evaluation and management of patients with lung disease.
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Affiliation(s)
- Warren B Gefter
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Kyung Soo Lee
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Mark L Schiebler
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Grace Parraga
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Joon Beom Seo
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Yoshiharu Ohno
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
| | - Hiroto Hatabu
- From the Department of Radiology, Penn Medicine, University of Pennsylvania, Philadelphia, Pa (W.B.G.); Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine (SKKU-SOM), Seoul, South Korea (K.S.L.); Department of Radiology, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wis (M.L.S.); Departments of Medicine and Medical Biophysics, Robarts Research Institute, Western University, London, Canada (G.P.); Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea (J.B.S.); Department of Radiology and Joint Research Laboratory of Advanced Medical Imaging, Fujita Health University School of Medicine, Toyoake, Japan (Y.O.); and Center for Pulmonary Functional Imaging, Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, 75 Francis St, Boston, MA 02215 (H.H.)
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11
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Ledoult E, Morelle M, Soussan M, Mékinian A, Béhal H, Sobanski V, Hachulla E, Huglo D, Le Gouellec N, Remy-Jardin M, Baillet C, Launay D. 18F-FDG positron emission tomography scanning in systemic sclerosis-associated interstitial lung disease: a pilot study. Arthritis Res Ther 2021; 23:76. [PMID: 33673861 PMCID: PMC7936499 DOI: 10.1186/s13075-021-02460-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Accepted: 02/22/2021] [Indexed: 12/15/2022] Open
Abstract
Background Interstitial lung disease is a common complication of systemic sclerosis (SSc-ILD), and it remains difficult to accurately predict its course. Progressing ILD could be more metabolically active, suggesting that the 18F-FDG tracer could be a tool in the managing of SSc-ILD. Methods In our center, SSc patients and controls (non-Hodgkin lymphoma cured after first-line regimen) who had received a PET/CT were screened retrospectively. The FDG uptake (visual intensity, pattern, SUVmax) was systematically recorded in > 30 regions of interest (ROIs) linked to SSc in a blind reviewing by 2 independent nuclear medicine physicians using a standardized form. Results Among the 545 SSc patients followed up in our center, 36, including 22 SSc-ILDs, had a PET/CT, whose indication was cancer screening in most cases. The mean ± SD age was 57.9 ± 13.0 years with 20/36 females. Fourteen patients had a disease duration of less than 2 years. A third had anti-centromere antibodies and 27.8% had anti-topoisomerase antibodies. Pulmonary FDG uptakes were higher in SSc patients than in controls (n = 89), especially in those with ILD compared with those without ILD. Pulmonary FDG uptakes were positively correlated with the ILD severity (fibrosis extent, %FVC, and %DLCO). No significant difference was found in the FDG uptakes from extrathoracic ROIs. Progressing SSc-ILDs within the 2 years after PET/CT (n = 9) had significant higher pulmonary FDG uptakes at baseline than stable SSc-ILDs (n = 13). Conclusion PET/CT could be a useful tool in the assessment of the severity and the prediction of pulmonary function outcome of SSc-ILD. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-021-02460-8.
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Affiliation(s)
- Emmanuel Ledoult
- Univ. Lille, INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France. .,Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000, Lille, France. .,Inserm, U1286, F-59000, Lille, France. .,Hôpital Claude Huriez, Service de Médecine Interne, Rue Michel Polonovski, F59037, Lille Cedex, France.
| | - Maxime Morelle
- CHU Lille, Service de Médecine Nucléaire, F-59000, Lille, France
| | - Michael Soussan
- CH Avicenne - APHP, Service de Médecine Nucléaire, F-93000, Bobigny, France
| | - Arsène Mékinian
- Hôpital Saint-Antoine - APHP, Service de Médecine Interne, F-75012, Paris, France.,Sorbonne Université, F-75571, Paris Cedex 12, France
| | - Hélène Béhal
- Univ. Lille, CHU Lille, ULR 2694 - METRICS : Évaluation des technologies de santé et des pratiques médicales, F-59000, Lille, France
| | - Vincent Sobanski
- Univ. Lille, INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000, Lille, France.,Inserm, U1286, F-59000, Lille, France
| | - Eric Hachulla
- Univ. Lille, INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000, Lille, France.,Inserm, U1286, F-59000, Lille, France
| | - Damien Huglo
- CHU Lille, Service de Médecine Nucléaire, F-59000, Lille, France.,Univ. Lille, Inserm, CHU Lille, U1189 - ONCO-THAI - Image Assisted Laser Therapy for Oncology, F-59000, Lille, France
| | - Noémie Le Gouellec
- Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000, Lille, France.,CH Valenciennes, Service de Médecine Interne, Centre de Compétences adultes pour les maladies auto-immunes et systémiques rares, F-59300, Valenciennes, France
| | - Martine Remy-Jardin
- Univ. Lille, CHU Lille, Service d'imagerie Thoracique, F-59000, Lille, France
| | - Clio Baillet
- CHU Lille, Service de Médecine Nucléaire, F-59000, Lille, France.,Univ. Lille, CHU Lille, EA 7365 - GRITA - Groupe de Recherche sur les formes Injectables et les Technologies Associées, F-59000, Lille, France
| | - David Launay
- Univ. Lille, INFINITE - Institute for Translational Research in Inflammation, F-59000, Lille, France.,Univ. Lille, CHU Lille, Service de Médecine Interne, Centre de Référence des Maladies Auto-immunes et Systémiques Rares du Nord et Nord-Ouest de France (CeRAINO), F-59000, Lille, France.,Inserm, U1286, F-59000, Lille, France
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12
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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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13
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Chen DL, Ballout S, Chen L, Cheriyan J, Choudhury G, Denis-Bacelar AM, Emond E, Erlandsson K, Fisk M, Fraioli F, Groves AM, Gunn RN, Hatazawa J, Holman BF, Hutton BF, Iida H, Lee S, MacNee W, Matsunaga K, Mohan D, Parr D, Rashidnasab A, Rizzo G, Subramanian D, Tal-Singer R, Thielemans K, Tregay N, van Beek EJR, Vass L, Vidal Melo MF, Wellen JW, Wilkinson I, Wilson FJ, Winkler T. Consensus Recommendations on the Use of 18F-FDG PET/CT in Lung Disease. J Nucl Med 2020; 61:1701-1707. [PMID: 32948678 PMCID: PMC9364897 DOI: 10.2967/jnumed.120.244780] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/09/2020] [Indexed: 01/04/2023] Open
Abstract
PET with 18F-FDG has been increasingly applied, predominantly in the research setting, to study drug effects and pulmonary biology and to monitor disease progression and treatment outcomes in lung diseases that interfere with gas exchange through alterations of the pulmonary parenchyma, airways, or vasculature. To date, however, there are no widely accepted standard acquisition protocols or imaging data analysis methods for pulmonary 18F-FDG PET/CT in these diseases, resulting in disparate approaches. Hence, comparison of data across the literature is challenging. To help harmonize the acquisition and analysis and promote reproducibility, we collated details of acquisition protocols and analysis methods from 7 PET centers. From this information and our discussions, we reached the consensus recommendations given here on patient preparation, choice of dynamic versus static imaging, image reconstruction, and image analysis reporting.
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Affiliation(s)
- Delphine L Chen
- Department of Radiology, University of Washington, Seattle Cancer Care Alliance, Seattle, Washington
| | - Safia Ballout
- School of Physics and Astronomy, University of Leeds, Leeds, United Kingdom
| | - Laigao Chen
- Worldwide Research, Development, and Medical, Pfizer Inc., Cambridge, Massachusetts
| | - Joseph Cheriyan
- Cambridge University Hospitals, NHS Foundation Trust, Cambridge, United Kingdom
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Gourab Choudhury
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Elise Emond
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Kjell Erlandsson
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Marie Fisk
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Francesco Fraioli
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Roger N Gunn
- inviCRO, London, United Kingdom
- Department of Medicine, Imperial College London, London, United Kingdom
| | - Jun Hatazawa
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University, Osaka, Japan
| | - Beverley F Holman
- Nuclear Medicine Department, Royal Free Hospital, London, United Kingdom
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Hidehiro Iida
- Faculty of Biomedicine and Turku PET Center, University of Turku, Turku, Finland
| | - Sarah Lee
- Amallis Consulting Ltd., London, United Kingdom
| | - William MacNee
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Keiko Matsunaga
- Department of Nuclear Medicine and Tracer Kinetics, Osaka University, Osaka, Japan
| | - Divya Mohan
- Medical Innovation, Value Evidence, and Outcomes, GlaxoSmithKline R&D, Collegeville, Pennsylvania
| | - David Parr
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | - Alaleh Rashidnasab
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Gaia Rizzo
- inviCRO, London, United Kingdom
- Department of Medicine, Imperial College London, London, United Kingdom
| | | | - Ruth Tal-Singer
- Medical Innovation, Value Evidence, and Outcomes, GlaxoSmithKline R&D, Collegeville, Pennsylvania
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Nicola Tregay
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Edwin J R van Beek
- Edinburgh Imaging, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Laurence Vass
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Marcos F Vidal Melo
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Jeremy W Wellen
- Research and Early Development, Celgene, Cambridge, Massachusetts; and
| | - Ian Wilkinson
- Cambridge University Hospitals, NHS Foundation Trust, Cambridge, United Kingdom
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Frederick J Wilson
- Clinical Imaging, Clinical Pharmacology, and Experimental Medicine, GlaxoSmithKline, Stevenage, United Kingdom
| | - Tilo Winkler
- Department of Anesthesia, Critical Care, and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
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14
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Türkkan G, Willems Y, Hendriks LEL, Mostard R, Conemans L, Gietema HA, Mitea C, Peeters S, De Ruysscher D. Idiopathic pulmonary fibrosis: Current knowledge, future perspectives and its importance in radiation oncology. Radiother Oncol 2020; 155:269-277. [PMID: 33245945 DOI: 10.1016/j.radonc.2020.11.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/01/2020] [Accepted: 11/17/2020] [Indexed: 02/06/2023]
Abstract
Idiopathic pulmonary fibrosis (IPF) is a progressive, fibrotic lung disease with an unknown cause. Uncertainties still remain regarding the pathogenesis of IPF, and the prognosis of this disease is poor despite some recent improvements in treatment. Radiation induced lung injury (RILI) is a common complication and a dose-limiting toxicity of thoracic radiotherapy. Importantly, IPF is a crucial risk factor for pulmonary toxicity after thoracic radiotherapy. Although IPF is not universally accepted as a definite contraindication for thoracic radiotherapy at present, it has been shown that IPF can increase the risk of severe and fatal complications after thoracic radiotherapy. Proton beam therapy has shown promising results in reducing the incidence of thoracic radiotherapy related life-threatening complications in IPF patients, but the current evidence is not sufficient to recommend the standard use of it. Many similarities are noticeable between IPF and RILI in terms of pathogenesis and underlying mechanisms. Better understanding of the mechanisms of IPF and RILI may enable clinicians to provide safer and more effective thoracic radiotherapy treatments in cancer patients with IPF. In this review, we summarize the current knowledge of IPF, present the importance of IPF in radiation oncology practice, and highlight the similarities and relationship between IPF and RILI.
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Affiliation(s)
- Görkem Türkkan
- Department of Radiation Oncology, MAASTRO Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands.
| | - Yves Willems
- Department of Radiation Oncology, MAASTRO Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Lizza E L Hendriks
- Department of Pulmonary Diseases, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Rémy Mostard
- Department of Respiratory Medicine, Zuyderland Medical Center Heerlen-Sittard, The Netherlands
| | - Lennart Conemans
- Department of Pulmonary Diseases, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Hester A Gietema
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Cristina Mitea
- Department of Radiology and Nuclear Medicine, Maastricht University Medical Centre+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Stéphanie Peeters
- Department of Radiation Oncology, MAASTRO Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Dirk De Ruysscher
- Department of Radiation Oncology, MAASTRO Clinic, Maastricht University Medical Center+, Maastricht, The Netherlands; GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
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15
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Aulakh GK, Kaur M, Brown V, Ekanayake S, Khan B, Fonge H. Quantification of regional murine ozone-induced lung inflammation using [ 18F]F-FDG microPET/CT imaging. Sci Rep 2020; 10:15699. [PMID: 32973318 PMCID: PMC7515916 DOI: 10.1038/s41598-020-72832-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 09/07/2020] [Indexed: 12/03/2022] Open
Abstract
Ozone (O3) is a highly potent and reactive air pollutant. It has been linked to acute and chronic respiratory diseases in humans by inducing inflammation. Our studies have found evidence that 0.05 ppm of O3, within the threshold of air quality standards, is capable of inducing acute lung injury. This study was undertaken to examine O3-induced lung damage using [18F]F-FDG (2-deoxy-2-[18F]fluoro-D-glucose) microPET/CT in wild-type mice. [18F]F-FDG is a known PET tracer for inflammation. Sequential [18F]F-FDG microPET/CT was performed at baseline (i.e. before O3 exposure), immediately (0 h), at 24 h and at 28 h following 2 h of 0.05 ppm O3 exposure. The images were quantified to determine O3 induced spatial standard uptake ratio of [18F]F-FDG in relation to lung tissue density and compared with baseline values. Immediately after O3 exposure, we detected a 72.21 ± 0.79% increase in lung [18F]F-FDG uptake ratio when compared to baseline measures. At 24 h post-O3 exposure, the [18F]F-FDG uptake becomes highly variable (S.D. in [18F]F-FDG = 5.174 × 10–4 units) with a 42.54 ± 0.33% increase in lung [18F]F-FDG compared to baseline. At 28 h time-point, [18F]F-FDG uptake ratio was similar to baseline values. However, the pattern of [18F]F-FDG distribution varied and was interspersed with zones of minimal uptake. Our microPET/CT imaging protocol can quantify and identify atypical regional lung uptake of [18F]F-FDG to understand the lung response to O3 exposure.
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Affiliation(s)
- G K Aulakh
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada.
| | - M Kaur
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - V Brown
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - S Ekanayake
- Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | - B Khan
- College of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - H Fonge
- College of Medicine, University of Saskatchewan, Saskatoon, Canada.,Department of Medical Imaging, RUH Saskatoon, Saskatoon, Canada
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16
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Vass L, Fisk M, Lee S, Wilson FJ, Cheriyan J, Wilkinson I. Advances in PET to assess pulmonary inflammation: A systematic review. Eur J Radiol 2020; 130:109182. [DOI: 10.1016/j.ejrad.2020.109182] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Revised: 05/27/2020] [Accepted: 07/07/2020] [Indexed: 12/12/2022]
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17
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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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Derlin T, Jaeger B, Jonigk D, Apel RM, Freise J, Shin HO, Weiberg D, Warnecke G, Ross TL, Wester HJ, Seeliger B, Welte T, Bengel FM, Prasse A. Clinical Molecular Imaging of Pulmonary CXCR4 Expression to Predict Outcome of Pirfenidone Treatment in Idiopathic Pulmonary Fibrosis. Chest 2020; 159:1094-1106. [PMID: 32822674 DOI: 10.1016/j.chest.2020.08.2043] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 08/03/2020] [Accepted: 08/10/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a progressive disease for which two antifibrotic drugs recently were approved. However, an unmet need exists to predict responses to antifibrotic treatment, such as pirfenidone. Recent data suggest that upregulated expression of CXCR4 is indicative of outcomes in IPF. RESEARCH QUESTION Can quantitative, molecular imaging of pulmonary CXCR4 expression as a biomarker for disease activity predict response to the targeted treatment pirfenidone and prognosis in patients with IPF? STUDY DESIGN AND METHODS CXCR4 expression was analyzed by immunohistochemistry examination of lung tissues and reverse-transcriptase polymerase chain reaction analysis of BAL. PET-CT scanning with the specific CXCR4 ligand 68Ga-pentixafor was performed in 28 IPF patients and compared with baseline clinical characteristics. In 16 patients, a follow-up scan was obtained 6 to 12 weeks after initiation of treatment with pirfenidone. Patients were followed up in our outpatient clinic for ≥ 12 months. RESULTS Immunohistochemistry analysis showed high CXCR4 staining of epithelial cells and macrophages in areas with vast fibrotic remodeling. Targeted PET scanning revealed CXCR4 upregulation in fibrotic areas of the lungs, particularly in zones with subpleural honeycombing. Baseline CXCR4 signal demonstrated a significant correlation with Gender Age Physiology stage (r = 0.44; P = .02) and with high-resolution CT scan score (r = 0.38; P = .04). Early changes in CXCR4 signal after initiation of pirfenidone treatment correlated with the long-term course of FVC after 12 months (r = -0.75; P = .0008). Moreover, patients with a high pulmonary CXCR4 signal on follow-up PET scan after 6 weeks into treatment demonstrated a statistically significant worse outcome at 12 months (P = .002). In multiple regression analysis, pulmonary CXCR4 signal on follow-up PET scan emerged as the only independent predictor of long-term outcome (P = .0226). INTERPRETATION CXCR4-targeted PET imaging identified disease activity and predicted outcome of IPF patients treated with pirfenidone. It may serve as a future biomarker for personalized guidance of antifibrotic treatment.
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Affiliation(s)
- Thorsten Derlin
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Benedikt Jaeger
- Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany
| | - Danny Jonigk
- Institute of Pathology, Hannover Medical School, Hannover, Germany
| | - Rosa M Apel
- Department of Pulmonology, Hannover Medical School, Hannover, Germany; DZL-BREATH, Hannover, Germany
| | - Julia Freise
- Department of Pulmonology, Hannover Medical School, Hannover, Germany; DZL-BREATH, Hannover, Germany
| | - Hoen-Oh Shin
- Institute of Radiology, Hannover Medical School, Hannover, Germany
| | - Desiree Weiberg
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Gregor Warnecke
- Department of Heart, Thoracic, Transplantation and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - Tobias L Ross
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Hans-Jürgen Wester
- Institute of Radiopharmaceutical Chemistry, Technical University Munich, Garching, Germany
| | - Benjamin Seeliger
- Department of Pulmonology, Hannover Medical School, Hannover, Germany; DZL-BREATH, Hannover, Germany
| | - Tobias Welte
- Department of Pulmonology, Hannover Medical School, Hannover, Germany; DZL-BREATH, Hannover, Germany
| | - Frank M Bengel
- Department of Nuclear Medicine, Hannover Medical School, Hannover, Germany
| | - Antje Prasse
- Department of Pulmonology, Hannover Medical School, Hannover, Germany; Fraunhofer Institute for Toxicology and Experimental Medicine, Hannover, Germany; DZL-BREATH, Hannover, Germany.
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Khor YH, Ng Y, Barnes H, Goh NSL, McDonald CF, Holland AE. Prognosis of idiopathic pulmonary fibrosis without anti-fibrotic therapy: a systematic review. Eur Respir Rev 2020; 29:29/157/190158. [PMID: 32759374 PMCID: PMC9488716 DOI: 10.1183/16000617.0158-2019] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Accepted: 02/04/2020] [Indexed: 01/17/2023] Open
Abstract
In addition to facilitating healthcare delivery planning, reliable information about prognosis is essential for treatment decisions in patients with idiopathic pulmonary fibrosis (IPF). This review aimed to evaluate the prognosis of patients with IPF without anti-fibrotic therapy. We included all cohort studies and the placebo arms of randomised controlled trials (RCTs) in IPF and follow-up of ≥12 months. Two reviewers independently evaluated studies for inclusion, assessed risk of bias and extracted data. A total of 154 cohort studies and 16 RCTs were included. The pooled proportions of mortality were 0.12 (95% CI 0.09–0.14) at 1–2 years, 0.38 (95% CI 0.34–0.42) between 2–5 years, and 0.69 (95% CI 0.59–0.78) at ≥5 years. The pooled mean overall survival was 4 years (95% CI 3.7–4.6) for studies with a follow-up duration of 10 years. At <2 years, forced vital capacity and diffusing capacity of the lung for carbon monoxide declined by a mean of 6.76% predicted (95% CI −8.92 −4.61) and 3% predicted (95% CI −5.14 −1.52), respectively. Although heterogeneity was high, subgroup analyses revealed lower pooled proportions of mortality at 1 year in the RCT participants (0.07 (95% CI 0.05–0.09)) versus cohort study participants (0.14 (95% CI 0.12–0.17)). This review provides comprehensive information on the prognosis of IPF, which can inform treatment discussions with patients and comparisons for future studies with new therapies. Without anti-fibrotic therapy, patients with IPF have a mortality rate of 31% at ≥5 years, and a mean overall survival of 4 years over 10 years of follow-uphttp://bit.ly/2SDiZSb
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Affiliation(s)
- Yet H Khor
- Dept of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia .,Institute for Breathing and Sleep, Heidelberg, Australia.,School of Medicine, University of Melbourne, Melbourne, Australia.,Dept of Respiratory Medicine, Alfred Health, Melbourne, Australia
| | - Yvonne Ng
- Monash Lung and Sleep, Monash Health, Clayton, Australia
| | - Hayley Barnes
- Dept of Respiratory Medicine, Alfred Health, Melbourne, Australia
| | - Nicole S L Goh
- Dept of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia.,Institute for Breathing and Sleep, Heidelberg, Australia.,School of Medicine, University of Melbourne, Melbourne, Australia.,Dept of Respiratory Medicine, Alfred Health, Melbourne, Australia
| | - Christine F McDonald
- Dept of Respiratory and Sleep Medicine, Austin Health, Heidelberg, Australia.,Institute for Breathing and Sleep, Heidelberg, Australia.,School of Medicine, University of Melbourne, Melbourne, Australia
| | - Anne E Holland
- Institute for Breathing and Sleep, Heidelberg, Australia.,Dept of Physiotherapy, Alfred Health and Monash University, Melbourne, Australia
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20
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Nishimura M, Tamaki N, Matsushima S, Kiba M, Kotani T, Bamba C, Nakamura Y, Yamada K. Dynamic whole-body 18F-FDG PET for differentiating abnormal lesions from physiological uptake. Eur J Nucl Med Mol Imaging 2020; 47:2293-2300. [PMID: 32189027 DOI: 10.1007/s00259-020-04726-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2019] [Accepted: 02/14/2020] [Indexed: 01/23/2023]
Abstract
PURPOSE Serial assessment of visual change in 18F-FDG uptake on whole-body 18F-FDG PET imaging was performed to differentiate pathological uptake from physiological uptake in the urinary and gastrointestinal tracts. METHODS In 88 suspected cancer patients, serial 3-min dynamic whole-body PET imaging was performed four times, from 60 min after 18F-FDG administration. In dynamic image evaluation, high 18F-FDG uptake was evaluated by two nuclear medicine physicians and classified as "changed" or "unchanged" based on change in uptake shape over time. Detectability of pathological uptake based on these criteria was assessed and compared with conventional image evaluation. RESULTS Dynamic whole-body PET imaging provided images of adequate quality for visual assessment. Dynamic image evaluation was "changed" in 118/154 regions of high physiological 18F-FDG uptake (77%): in 9/19 areas in the stomach (47%), in 32/39 in the small intestine (82%), in 17/33 in the colon (52%), and in 60/63 in the urinary tract (95%). In the 86 benign or malignant lesions, 84 lesions (98%) were "unchanged." A high 18F-FDG uptake area that shows no change over time using these criteria is highly likely to represent pathological uptake, with sensitivity of 97%, specificity of 76%, PPV of 70%, NPV of 98%, and accuracy of 84%. CONCLUSION Dynamic whole-body 18F-FDG PET imaging enabled differentiation of pathological uptake from physiological uptake in the urinary and gastrointestinal tracts, based on visual change of uptake shape.
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Affiliation(s)
- Motoki Nishimura
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
| | - Shigenori Matsushima
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Maki Kiba
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Tomoya Kotani
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Chisa Bamba
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Yasunori Nakamura
- Department of Radiological Technology, University Hospital, Kyoto Prefectural University of Medicine, Kyoto, Japan
| | - Kei Yamada
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan
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21
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Cho SJ, Moon JS, Nikahira K, Yun HS, Harris R, Hong KS, Huang H, Choi AMK, Stout-Delgado H. GLUT1-dependent glycolysis regulates exacerbation of fibrosis via AIM2 inflammasome activation. Thorax 2020; 75:227-236. [PMID: 31822523 PMCID: PMC7063401 DOI: 10.1136/thoraxjnl-2019-213571] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Revised: 10/24/2019] [Accepted: 11/16/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a rapidly progressive, fatal lung disease that affects older adults. One of the detrimental natural histories of IPF is acute exacerbation of IPF (AE-IPF), of which bacterial infection is reported to play an important role. However, the mechanism by which bacterial infection modulates the fibrotic response remains unclear. OBJECTIVES Altered glucose metabolism has been implicated in the pathogenesis of fibrotic lung diseases. We have previously demonstrated that glucose transporter 1 (GLUT1)-dependent glycolysis regulates fibrogenesis in a murine fibrosis model. To expand on these findings, we hypothesised that GLUT1-dependent glycolysis regulates acute exacerbation of lung fibrogenesis during bacterial infection via AIM2 inflammasome activation. RESULTS In our current study, using a murine model of Streptococcus pneumoniae (S. pneumoniae) infection, we investigated the potential role of GLUT1 on mediating fibrotic responses to an acute exacerbation during bleomycin-induced fibrosis. The results of our current study illustrate that GLUT1 deficiency ameliorates S. pneumoniae-mediated exacerbation of lung fibrosis (wild type (WT)/phosphate buffered saline (PBS), n=3; WT/S. pneumoniae, n=3; WT/Bleomycin, n=5 ; WT/Bleomycin+S. pneumoniae, n=7; LysM-Cre-Glut1fl/f /PBS, n=3; LysM-Cre-Glut1fl/fl /S. pneumoniae, n=3; LysM-Cre-Glut1fl/fl /Bleomycin, n=6; LysM-Cre-Glut1fl/fl /Bleomycin+S. pneumoniae, n=9, p=0.041). Further, the AIM2 inflammasome, a multiprotein complex essential for sensing cytosolic bacterial DNA as a danger signal, is an important regulator of this GLUT1-mediated fibrosis and genetic deficiency of AIM2 reduced bleomycin-induced fibrosis after S. pneumoniae infection (WT/PBS, n=6; WT/Bleomycin+S. pneumoniae, n=15; Aim2-/-/PBS, n=6, Aim2-/-/Bleomycin+S. pneumoniae, n=11, p=0.034). GLUT1 deficiency reduced expression and function of the AIM2 inflammasome, and AIM2-deficient mice showed substantial reduction of lung fibrosis after S. pneumoniae infection. CONCLUSION Our results demonstrate that GLUT1-dependent glycolysis promotes exacerbation of lung fibrogenesis during S. pneumoniae infection via AIM2 inflammasome activation.
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Affiliation(s)
- Soo Jung Cho
- Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Jong-Seok Moon
- Department of Integrated Biomedical Science, Soonchunhyang Institute of Medi-bio Science (SIMS), Soon Chun Hyang University, Asan, Chungcheongnam-do, Korea
| | - Kiichi Nikahira
- Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Ha Seon Yun
- Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Rebecca Harris
- Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Kyung Sook Hong
- Medicine, Weill Cornell Medical College, New York City, New York, USA
| | - Huarong Huang
- Medicine, Weill Cornell Medical College, New York City, New York, USA
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22
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Yamamichi T, Shimada Y, Masuno R, Ohira T, Abe S, Yoshimura A, Ikeda N. Association between F-18 fluorodeoxyglucose uptake of noncancerous lung area and acute exacerbation of interstitial pneumonia in patients with lung cancer after resection. J Thorac Cardiovasc Surg 2020; 159:1111-1118.e2. [DOI: 10.1016/j.jtcvs.2019.07.100] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Revised: 07/24/2019] [Accepted: 07/25/2019] [Indexed: 01/23/2023]
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23
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Weatherley ND, Eaden JA, Stewart NJ, Bartholmai BJ, Swift AJ, Bianchi SM, Wild JM. Experimental and quantitative imaging techniques in interstitial lung disease. Thorax 2019; 74:611-619. [PMID: 30886067 PMCID: PMC6585263 DOI: 10.1136/thoraxjnl-2018-211779] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 01/05/2019] [Accepted: 01/14/2019] [Indexed: 01/19/2023]
Abstract
Interstitial lung diseases (ILDs) are a heterogeneous group of conditions, with a wide and complex variety of imaging features. Difficulty in monitoring, treating and exploring novel therapies for these conditions is in part due to the lack of robust, readily available biomarkers. Radiological studies are vital in the assessment and follow-up of ILD, but currently CT analysis in clinical practice is qualitative and therefore somewhat subjective. In this article, we report on the role of novel and quantitative imaging techniques across a range of imaging modalities in ILD and consider how they may be applied in the assessment and understanding of ILD. We critically appraised evidence found from searches of Ovid online, PubMed and the TRIP database for novel and quantitative imaging studies in ILD. Recent studies have explored the capability of texture-based lung parenchymal analysis in accurately quantifying several ILD features. Newer techniques are helping to overcome the challenges inherent to such approaches, in particular distinguishing peripheral reticulation of lung parenchyma from pleura and accurately identifying the complex density patterns that accompany honeycombing. Robust and validated texture-based analysis may remove the subjectivity that is inherent to qualitative reporting and allow greater objective measurements of change over time. In addition to lung parenchymal feature quantification, pulmonary vessel volume analysis on CT has demonstrated prognostic value in two retrospective analyses and may be a sign of vascular changes in ILD which, to date, have been difficult to quantify in the absence of overt pulmonary hypertension. Novel applications of existing imaging techniques, such as hyperpolarised gas MRI and positron emission tomography (PET), show promise in combining structural and functional information. Although structural imaging of lung tissue is inherently challenging in terms of conventional proton MRI techniques, inroads are being made with ultrashort echo time, and dynamic contrast-enhanced MRI may be used for lung perfusion assessment. In addition, inhaled hyperpolarised 129Xenon gas MRI may provide multifunctional imaging metrics, including assessment of ventilation, intra-acinar gas diffusion and alveolar-capillary diffusion. PET has demonstrated high standard uptake values (SUVs) of 18F-fluorodeoxyglucose in fibrosed lung tissue, challenging the assumption that these are ‘burned out’ and metabolically inactive regions. Regions that appear structurally normal also appear to have higher SUV, warranting further exploration with future longitudinal studies to assess if this precedes future regions of macroscopic structural change. Given the subtleties involved in diagnosing, assessing and predicting future deterioration in many forms of ILD, multimodal quantitative lung structure-function imaging may provide the means of identifying novel, sensitive and clinically applicable imaging markers of disease. Such imaging metrics may provide mechanistic and phenotypic information that can help direct appropriate personalised therapy, can be used to predict outcomes and could potentially be more sensitive and specific than global pulmonary function testing. Quantitative assessment may objectively assess subtle change in character or extent of disease that can assist in efficacy of antifibrotic therapy or detecting early changes of potentially pneumotoxic drugs involved in early intervention studies.
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Affiliation(s)
| | - James A Eaden
- Academic Unit of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Neil J Stewart
- Academic Unit of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Brian J Bartholmai
- Department of Radiology, Mayo Clinic Minnesota, Rochester, Minnesota, USA
| | - Andrew J Swift
- Academic Unit of Academic Radiology, University of Sheffield, Sheffield, UK
| | - Stephen Mark Bianchi
- Department of Respiratory Medicine, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Jim M Wild
- Academic Unit of Academic Radiology, University of Sheffield, Sheffield, UK
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24
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Flechsig P, Hural O, Kreuter M, Eichhorn M, HEUßEL G, Sachpekidis C, Kauczor HU, Haberkorn U, Heussel CP, Eichinger M. Impact of FDG-PET on the Detection of Patients with Lung Cancer at High Risk for ILD. In Vivo 2019; 32:1457-1462. [PMID: 30348701 DOI: 10.21873/invivo.11399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 06/25/2018] [Accepted: 06/28/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND/AIM Idiopathic pulmonary fibrosis IPF is a type of interstitial lung disease (ILD) with poor prognosis. Lung cancer (LC) is a frequent complication in IPF, where all therapeutic options are potential triggers for acute exacerbation of IPF. PATIENTS AND METHODS Patients with 2-deoxy-2-fluoro-D-glucose-positron emission tomography/computer tomography (FDG-PET/CT) results before lobectomy for LC with and without (n=10 each) signs of ILD in initial imaging and after-care CT were retrospectively analyzed. FDG uptake was calculated as the maximum standardized uptake value (SUVmax) in the lung periphery divided by the SUVmax of the mediastinal blood pool (rSUVmax). Regional increase of fibrosis and ground-glass features in lobe-based CT analysis was used as standard reference. RESULTS Patients with LC with ILD presented a significantly higher rSUVmax of 0.57 compared to patients without ILD with rSUVmax 0.47 (p<0.001). CONCLUSION rSUVmax seems to be a valuable imaging surrogate in predicting patients with LC with increased risk for progressive ILD associated with thoracic surgery.
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Affiliation(s)
- Paul Flechsig
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany .,Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Olena Hural
- Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Michael Kreuter
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Martin Eichhorn
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Department of Thoracic Surgery, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Gudula HEUßEL
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany.,Department of Thoracic Surgery, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Christos Sachpekidis
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Clinical Cooperation Unit, Department of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Hans-Ulrich Kauczor
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany
| | - Uwe Haberkorn
- Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany.,Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Clinical Cooperation Unit, Department of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Claus Peter Heussel
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
| | - Monika Eichinger
- Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany.,Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany
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25
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Castiaux A, Van Simaeys G, Goldman S, Bondue B. Assessment of 18F-FDG uptake in idiopathic pulmonary fibrosis: influence of lung density changes. Eur J Hybrid Imaging 2018. [DOI: 10.1186/s41824-018-0045-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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26
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Pulmonary 18F-FDG uptake helps refine current risk stratification in idiopathic pulmonary fibrosis (IPF). Eur J Nucl Med Mol Imaging 2018; 45:806-815. [PMID: 29335764 PMCID: PMC5978900 DOI: 10.1007/s00259-017-3917-8] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2017] [Accepted: 12/14/2017] [Indexed: 12/11/2022]
Abstract
Purpose There is a lack of prognostic biomarkers in idiopathic pulmonary fibrosis (IPF) patients. The objective of this study is to investigate the potential of 18F-FDG-PET/ CT to predict mortality in IPF. Methods A total of 113 IPF patients (93 males, 20 females, mean age ± SD: 70 ± 9 years) were prospectively recruited for 18F-FDG-PET/CT. The overall maximum pulmonary uptake of 18F-FDG (SUVmax), the minimum pulmonary uptake or background lung activity (SUVmin), and target-to-background (SUVmax/ SUVmin) ratio (TBR) were quantified using routine region-of-interest analysis. Kaplan–Meier analysis was used to identify associations of PET measurements with mortality. We also compared PET associations with IPF mortality with the established GAP (gender age and physiology) scoring system. Cox analysis assessed the independence of the significant PET measurement(s) from GAP score. We investigated synergisms between pulmonary 18F-FDG-PET measurements and GAP score for risk stratification in IPF patients. Results During a mean follow-up of 29 months, there were 54 deaths. The mean TBR ± SD was 5.6 ± 2.7. Mortality was associated with high pulmonary TBR (p = 0.009), low forced vital capacity (FVC; p = 0.001), low transfer factor (TLCO; p < 0.001), high GAP index (p = 0.003), and high GAP stage (p = 0.003). Stepwise forward-Wald–Cox analysis revealed that the pulmonary TBR was independent of GAP classification (p = 0.010). The median survival in IPF patients with a TBR < 4.9 was 71 months, whilst in those with TBR > 4.9 was 24 months. Combining PET data with GAP data (“PET modified GAP score”) refined the ability to predict mortality. Conclusions A high pulmonary TBR is independently associated with increased risk of mortality in IPF patients. Electronic supplementary material The online version of this article (10.1007/s00259-017-3917-8) contains supplementary material, which is available to authorized users.
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27
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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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Cho SJ, Moon JS, Lee CM, Choi AMK, Stout-Delgado HW. Glucose Transporter 1-Dependent Glycolysis Is Increased during Aging-Related Lung Fibrosis, and Phloretin Inhibits Lung Fibrosis. Am J Respir Cell Mol Biol 2017; 56:521-531. [PMID: 27997810 DOI: 10.1165/rcmb.2016-0225oc] [Citation(s) in RCA: 86] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aging is associated with metabolic diseases such as type 2 diabetes mellitus, cardiovascular disease, cancer, and neurodegeneration. Aging contributes to common processes including metabolic dysfunction, DNA damage, and reactive oxygen species generation. Although glycolysis has been linked to cell growth and proliferation, the mechanisms by which the activation of glycolysis by aging regulates fibrogenesis in the lung remain unclear. The objective of this study was to determine if glucose transporter 1 (GLUT1)-induced glycolysis regulates age-dependent fibrogenesis of the lung. Mouse and human lung tissues were analyzed for GLUT1 and glycolytic markers using immunoblotting. Glycolytic function was measured using a Seahorse apparatus. To study the effect of GLUT1, genetic inhibition of GLUT1 was performed by short hairpin RNA transduction, and phloretin was used for pharmacologic inhibition of GLUT1. GLUT1-dependent glycolysis is activated in aged lung. Genetic and pharmacologic inhibition of GLUT1 suppressed the protein expression of α-smooth muscle actin, a key cytoskeletal component of activated fibroblasts, in mouse primary lung fibroblast cells. Moreover, we demonstrated that the activation of AMP-activated protein kinase, which is regulated by GLUT1-dependent glycolysis, represents a critical metabolic pathway for fibroblast activation. Furthermore, we demonstrated that phloretin, a potent inhibitor of GLUT1, significantly inhibited bleomycin-induced lung fibrosis in vivo. These results suggest that GLUT1-dependent glycolysis regulates fibrogenesis in aged lung and that inhibition of GLUT1 provides a potential target of therapy of age-related lung fibrosis.
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Affiliation(s)
- Soo Jung Cho
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York; and
| | - Jong-Seok Moon
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York; and
| | - Chang-Min Lee
- 3 Department of Molecular Microbiology and Immunology, Brown University, Providence, Rhode Island
| | - Augustine M K Choi
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York; and
| | - Heather W Stout-Delgado
- 1 Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, New York.,2 Division of Pulmonary and Critical Care Medicine, Weill Cornell Medical College, New York, New York; and
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29
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Justet A, Laurent-Bellue A, Thabut G, Dieudonné A, Debray MP, Borie R, Aubier M, Lebtahi R, Crestani B. [ 18F]FDG PET/CT predicts progression-free survival in patients with idiopathic pulmonary fibrosis. Respir Res 2017; 18:74. [PMID: 28449678 PMCID: PMC5408423 DOI: 10.1186/s12931-017-0556-3] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 04/18/2017] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Idiopathic pulmonary fibrosis (IPF) is a devastating disease characterized by an unpredictable course. Prognostic markers and disease activity markers are needed. The purpose of this single-center retrospective study was to evaluate the prognostic value of lung fluorodeoxyglucose ([18F]-FDG) uptake assessed by standardized uptake value (SUV), metabolic lung volume (MLV) and total lesion glycolysis (TLG) in patients with IPF. METHODS We included 27 IPF patients (IPF group) and 15 patients with a gastrointestinal neuroendocrine tumor without thoracic involvement (control group). We quantified lung SUV mean and SUV max, MLV and TLG and assessed clinical data, high-resolution CT (HRCT) fibrosis and ground-glass score; lung function; gender, age, physiology (GAP) stage at inclusion and during follow-up; and survival. RESULTS Lung SUV mean and SUV max were higher in IPF patients than controls (p <0.00001). For patients with IPF, SUV mean, SUV max, MLV and TLG were correlated with severity of lung involvement as measured by a decline in forced vital capacity (FVC) and diffusing capacity of the lungs for carbon monoxide (DLCO) and increased GAP score. In a univariate and in a multivariate Cox proportional-hazards model, risk of death was increased although not significantly with high SUV mean. On univariate analysis, risk of death was significantly associated with high TLG and MLV, which disappeared after adjustment functional variables or GAP index. Increased MLV and TLG were independent predictors of death or disease progression during the 12 months after PET scan completion (for every 100-point increase in TLG, hazard ratio [HR]: 1.11 (95% CI 1.06; 1.36), p = 0.003; for every 100-point increase in MLV, HR: 1.20 (1.04; 1.19), p = 0.002). On multivariable analysis including TLG or MLV with age, FVC, and DLCO or GAP index, TLG and MLV remained associated with progression-free survival (HR: 1.1 [1.03; 1.22], p = 0.01; and 1.13 [1.0; 1.2], p = 0.005). CONCLUSION FDG lung uptake may be a marker of IPF severity and predict progression-free survival for patients with IPF.
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Affiliation(s)
- Aurélien Justet
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, 46 rue Henri Huchard, 75018, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
| | | | - Gabriel Thabut
- APHP, Hôpital Bichat, Service de Pneumologie et de Transplantation Pulmonaire, DHU FIRE, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Arnaud Dieudonné
- APHP, Hôpital Beaujon Service de Médecine nucléaire, Clichy, France
| | | | - Raphael Borie
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, 46 rue Henri Huchard, 75018, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Michel Aubier
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, 46 rue Henri Huchard, 75018, Paris, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Rachida Lebtahi
- APHP, Hôpital Beaujon Service de Médecine nucléaire, Clichy, France.,Université Paris Diderot, Sorbonne Paris Cité, Paris, France
| | - Bruno Crestani
- APHP, Hôpital Bichat, Service de Pneumologie A, DHU FIRE, Centre de compétence des maladies pulmonaires rares, 46 rue Henri Huchard, 75018, Paris, France. .,Université Paris Diderot, Sorbonne Paris Cité, Paris, France.
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30
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Désogère P, Tapias LF, Hariri LP, Rotile NJ, Rietz TA, Probst CK, Blasi F, Day H, Mino-Kenudson M, Weinreb P, Violette SM, Fuchs BC, Tager AM, Lanuti M, Caravan P. Type I collagen-targeted PET probe for pulmonary fibrosis detection and staging in preclinical models. Sci Transl Med 2017; 9:eaaf4696. [PMID: 28381537 PMCID: PMC5568793 DOI: 10.1126/scitranslmed.aaf4696] [Citation(s) in RCA: 105] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Revised: 10/20/2016] [Accepted: 03/16/2017] [Indexed: 12/26/2022]
Abstract
Pulmonary fibrosis is scarring of the lungs that can arise from radiation injury, drug toxicity, environmental or genetic causes, and for unknown reasons [idiopathic pulmonary fibrosis (IPF)]. Overexpression of collagen is a hallmark of organ fibrosis. We describe a peptide-based positron emission tomography (PET) probe (68Ga-CBP8) that targets collagen type I. We evaluated 68Ga-CBP8 in vivo in the bleomycin-induced mouse model of pulmonary fibrosis. 68Ga-CBP8 showed high specificity for pulmonary fibrosis and high target/background ratios in diseased animals. The lung PET signal and lung 68Ga-CBP8 uptake (quantified ex vivo) correlated linearly (r2 = 0.80) with the amount of lung collagen in mice with fibrosis. We further demonstrated that the 68Ga-CBP8 probe could be used to monitor response to treatment in a second mouse model of pulmonary fibrosis associated with vascular leak. Ex vivo analysis of lung tissue from patients with IPF supported the animal findings. These studies indicate that 68Ga-CBP8 is a promising candidate for noninvasive imaging of human pulmonary fibrosis.
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Affiliation(s)
- Pauline Désogère
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Luis F Tapias
- Division of Thoracic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Lida P Hariri
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Nicholas J Rotile
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Tyson A Rietz
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Clemens K Probst
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Francesco Blasi
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Helen Day
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA
| | - Mari Mino-Kenudson
- Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | | | | | - Bryan C Fuchs
- Division of Surgical Oncology, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Andrew M Tager
- Division of Pulmonary and Critical Care Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA
| | - Michael Lanuti
- Division of Thoracic Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, MA 02114, USA.
| | - Peter Caravan
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA 02129, USA.
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31
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Chen DL, Cheriyan J, Chilvers ER, Choudhury G, Coello C, Connell M, Fisk M, Groves AM, Gunn RN, Holman BF, Hutton BF, Lee S, MacNee W, Mohan D, Parr D, Subramanian D, Tal-Singer R, Thielemans K, van Beek EJR, Vass L, Wellen JW, Wilkinson I, Wilson FJ. Quantification of Lung PET Images: Challenges and Opportunities. J Nucl Med 2017; 58:201-207. [PMID: 28082432 DOI: 10.2967/jnumed.116.184796] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Accepted: 01/10/2017] [Indexed: 01/03/2023] Open
Abstract
Millions of people are affected by respiratory diseases, leading to a significant health burden globally. Because of the current insufficient knowledge of the underlying mechanisms that lead to the development and progression of respiratory diseases, treatment options remain limited. To overcome this limitation and understand the associated molecular changes, noninvasive imaging techniques such as PET and SPECT have been explored for biomarker development, with 18F-FDG PET imaging being the most studied. The quantification of pulmonary molecular imaging data remains challenging because of variations in tissue, air, blood, and water fractions within the lungs. The proportions of these components further differ depending on the lung disease. Therefore, different quantification approaches have been proposed to address these variabilities. However, no standardized approach has been developed to date. This article reviews the data evaluating 18F-FDG PET quantification approaches in lung diseases, focusing on methods to account for variations in lung components and the interpretation of the derived parameters. The diseases reviewed include acute respiratory distress syndrome, chronic obstructive pulmonary disease, and interstitial lung diseases such as idiopathic pulmonary fibrosis. Based on review of prior literature, ongoing research, and discussions among the authors, suggested considerations are presented to assist with the interpretation of the derived parameters from these approaches and the design of future studies.
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Affiliation(s)
- Delphine L Chen
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, Missouri
| | - Joseph Cheriyan
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom.,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Edwin R Chilvers
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Gourab Choudhury
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | | | - Martin Connell
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Marie Fisk
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Ashley M Groves
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Roger N Gunn
- Imanova Ltd., London, United Kingdom.,Department of Medicine, Imperial College London, London, United Kingdom
| | - Beverley F Holman
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Brian F Hutton
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Sarah Lee
- Medical Image Analysis Consultant, London, United Kingdom
| | - William MacNee
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Divya Mohan
- Clinical Discovery, Respiratory Therapy Area Unit, GlaxoSmithKline R&D, King of Prussia, Pennsylvania
| | - David Parr
- University Hospitals Coventry and Warwickshire, Coventry, United Kingdom
| | | | - Ruth Tal-Singer
- Clinical Discovery, Respiratory Therapy Area Unit, GlaxoSmithKline R&D, King of Prussia, Pennsylvania
| | - Kris Thielemans
- Institute of Nuclear Medicine, University College London, London, United Kingdom
| | - Edwin J R van Beek
- Queen's Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
| | - Laurence Vass
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Jeremy W Wellen
- Worldwide Research and Development, Pfizer, Inc., Cambridge, Massachusetts; and
| | - Ian Wilkinson
- Department of Medicine, University of Cambridge, Cambridge, United Kingdom.,Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - Frederick J Wilson
- Experimental Medicine Imaging, GlaxoSmithKline, Stevenage, United Kingdom
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32
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Abstract
Lung inflammatory diseases contribute significantly to the socioeconomic burden of disease. Yet very few new, effective therapies for respiratory disease have been approved for use. A major contributing factor is the lack of biomarkers that can accurately quantify the lung inflammatory burden and can be used to understand the contribution of lung inflammation to loss in lung function. Molecular imaging approaches can detect and quantify the recruitment and activation of specific immune cells in lung inflammation. We review the clinical techniques used to image lung inflammation, provide an overview of clinical and emerging PET techniques for quantifying lung inflammation, and discuss potential clinical applications.
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Affiliation(s)
| | - Delphine L Chen
- Washington University School of Medicine, St. Louis, Missouri
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