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- Title
Quantitative analysis of dynamic F-FDG PET/CT for measurement of lung inflammation.
- Authors
Coello, Christopher; Fisk, Marie; Mohan, Divya; Wilson, Frederick; Brown, Andrew; Polkey, Michael; Wilkinson, Ian; Tal-Singer, Ruth; Murphy, Philip; Cheriyan, Joseph; Gunn, Roger
- Abstract
Background: An inflammatory reaction in the airways and lung parenchyma, comprised mainly of neutrophils and alveolar macrophages, is present in some patients with chronic obstructive pulmonary disease (COPD). Thoracic fluorodeoxyglucose (F-FDG) positron emission tomography (PET) has been proposed as a promising imaging biomarker to assess this inflammation. We sought to introduce a fully quantitative analysis method and compare this with previously published studies based on the Patlak approach using a dataset comprising F-FDG PET scans from COPD subjects with elevated circulating inflammatory markers (fibrinogen) and matched healthy volunteers (HV). Dynamic F-FDG PET scans were obtained for high-fibrinogen (>2.8 g/l) COPD subjects ( N = 10) and never smoking HV ( N = 10). Lungs were segmented using co-registered computed tomography images and subregions (upper, middle and lower) were semi-automatically defined. A quantitative analysis approach was developed, which corrects for the presence of air and blood in the lung ( qABL method), enabling direct estimation of the metabolic rate of FDG in lung tissue. A normalised Patlak analysis approach was also performed to enable comparison with previously published results. Effect sizes (Hedge's g) were used to compare HV and COPD groups. Results: The qABL method detected no difference (Hedge's g = 0.15 [−0.76 1.04]) in the tissue metabolic rate of FDG in the whole lung between HV ( μ = 6.0 ± 1.9 × 10 ml cm min) and COPD ( μ = 5.7 ± 1.7 × 10 ml cm min). However, analysis with the normalised Patlak approach detected a significant difference (Hedge's g = −1.59 [−2.57 −0.48]) in whole lung between HV ( μ = 2.9 ± 0.5 × 10 ml cm min) and COPD ( μ = 3.9 ± 0.7 × 10 ml cm min). The normalised Patlak endpoint was shown to be a composite measure influenced by air volume, blood volume and actual uptake of F-FDG in lung tissue. Conclusions: We have introduced a quantitative analysis method that provides a direct estimate of the metabolic rate of FDG in lung tissue. This work provides further understanding of the underlying origin of the F-FDG signal in the lung in disease groups and helps interpreting changes following standard or novel therapies.
- Subjects
LUNG disease diagnosis; PNEUMONIA diagnosis; POSITRON emission tomography; OBSTRUCTIVE lung diseases; LUNG physiology
- Publication
EJNMMI Research, 2017, Vol 7, Issue 1, p1
- ISSN
2191-219X
- Publication type
Article
- DOI
10.1186/s13550-017-0291-2