Department of Nuclear Medicine, St Antonius Hospital, Postbox 2500, 3430 EM, Nieuwegein, The Netherlands.
Eur J Nucl Med Mol Imaging. 2010 Jun;37(6):1181-8. doi: 10.1007/s00259-009-1376-6. Epub 2010 Feb 16.
Bronchoalveolar lavage (BAL) and (18)F-fluorodeoxyglucose ((18)F-FDG) PET can both demonstrate sarcoid activity. To assess whether metabolic activity imaged by (18)F-FDG PET represents signs of disease activity as reflected by BAL, (18)F-FDG PET patterns were compared with BAL cell profiles.
In this retrospective analysis, 77 newly diagnosed pulmonary sarcoidosis patients underwent BAL and (18)F-FDG PET. Based on (18)F-FDG PET, patients were diagnosed with exclusively mediastinal/hilar activity (group A) and activity in the lung parenchyma (group B). Per group, BAL lymphocytes (%), CD4/CD8 ratio, CD103(+)CD4(+)/CD4(+) ratio and neutrophils (%) were compared with the extent of metabolic activity expressed as the maximum standardized uptake value (SUV(max)). Additionally, SUV(max) and BAL parameters per radiographic stage were analysed.
Overall, the SUV(max) in the lung parenchyma correlated with neutrophils and SUV(max) of the mediastinum/hila correlated with the CD4/CD8 ratio. In both groups, a significant, negative correlation between the SUV(max) of the mediastinum/hila and the CD103(+)CD4(+)/CD4(+) ratio was found. In group B, the SUV(max) of the mediastinum/hila correlated with the CD4/CD8 ratio, while the SUV(max) in the lung parenchyma correlated with the CD103(+)CD4(+)/CD4(+) ratio and neutrophils. Significant differences were found in the SUV(max), CD4/CD8 ratio, CD103(+)CD4(+)/CD4(+) ratio and neutrophils between the radiographic stages. The SUV(max) of the lung parenchyma was positively related to the radiographic stage, while the SUV(max) of the mediastinum/hila and CD4/CD8 ratio were inversely related.
(18)F-FDG PET correlates with the CD4/CD8 ratio and neutrophils, suggesting that (18)F-FDG PET represents this specific cell profile in BAL. High SUV(max) values of the lung parenchyma may therefore correlate with more severe parenchymal involvement, particularly when accompanied by a low SUV(max) of the mediastinum/hila.
支气管肺泡灌洗（BAL）和（18）F-氟脱氧葡萄糖（（18）F-FDG）PET 均可显示结节病活动。为了评估 18F-FDG PET 代谢活性是否代表 BAL 反映的疾病活动的迹象，比较了 18F-FDG PET 模式与 BAL 细胞特征。
在这项回顾性分析中，77 例新诊断的肺结节病患者接受了 BAL 和（18）F-FDG PET。根据（18）F-FDG PET，患者被诊断为仅纵隔/肺门活性（A 组）和肺实质活性（B 组）。根据组，比较 BAL 淋巴细胞（%）、CD4/CD8 比值、CD103+CD4+/CD4+比值和中性粒细胞（%）与代谢活性的最大标准化摄取值（SUV（max））。此外，还分析了 SUV（max）和每个影像学阶段的 BAL 参数。
总体而言，肺实质的 SUV（max）与中性粒细胞相关，纵隔/肺门的 SUV（max）与 CD4/CD8 比值相关。在两组中，纵隔/肺门的 SUV（max）与 CD103+CD4+/CD4+比值之间均存在显著的负相关。在 B 组中，纵隔/肺门的 SUV（max）与 CD4/CD8 比值相关，而肺实质的 SUV（max）与 CD103+CD4+/CD4+比值和中性粒细胞相关。在不同的影像学阶段，SUV（max）、CD4/CD8 比值、CD103+CD4+/CD4+比值和中性粒细胞均有显著差异。肺实质的 SUV（max）与影像学阶段呈正相关，而纵隔/肺门的 SUV（max）和 CD4/CD8 比值与影像学阶段呈负相关。
（18）F-FDG PET 与 CD4/CD8 比值和中性粒细胞相关，提示（18）F-FDG PET 代表 BAL 中的这种特定细胞特征。因此，肺实质的高 SUV（max）值可能与更严重的实质受累相关，特别是当伴有纵隔/肺门 SUV（max）较低时。
