Adams Human, van Rooij Rob, van Moorsel Coline H M, Spee-Dropkova Marcela, Grutters Jan C, Keijsers Ruth G
Department of Pulmonology, ILD Center of Excellence, St. Antonius Hospital, the Netherlands.
Department of Nuclear Medicine, Green Heart Hospital, the Netherlands.
Sarcoidosis Vasc Diffuse Lung Dis. 2018;35(1):44-54. doi: 10.36141/svdld.v35i1.5807. Epub 2018 Apr 28.
Currently FDG PET/CT is used as a tool for detection of active sites of sarcoidosis. Routine clinical practice relies on qualitative assessment with visual interpretation. When semi quantitatively expressed, e.g. for scientific purposes, this often leads to dichotomous "positive" or "negative" results. Metabolic activity in the lungs or mediastinum can also be expressed by SUVmax, but this measure is based only on the intensity of a single voxel. Likely for this reason these parameters show poor correlation with variables such as serum biomarkers and suboptimally predict clinical response to treatment. The current study focusses on new volumetric quantification methods for FDG PET/CT. Specifically the percentage of lung volume with increased metabolic activity, "%SUV-high", and the average metabolic activity in the lung "SUVmean", shows significantly better correlation with conventional biomarkers for disease activity than PET dichotomous and SUVmax. Our proposed quantification method needs subsequent and larger studies, however it may open new possibilities for future quantitative research in lung inflammation, and improve precision medicine in sarcoidosis. .
目前，氟代脱氧葡萄糖正电子发射断层显像/计算机断层扫描（FDG PET/CT）被用作检测结节病活动部位的工具。常规临床实践依赖于通过视觉解读进行定性评估。当进行半定量表达时，例如用于科学目的，这通常会导致二分法的“阳性”或“阴性”结果。肺或纵隔的代谢活性也可以用最大标准摄取值（SUVmax）来表示，但该指标仅基于单个体素的强度。可能正是由于这个原因，这些参数与血清生物标志物等变量的相关性较差，并且对治疗临床反应的预测效果欠佳。当前的研究聚焦于FDG PET/CT的新体积量化方法。具体而言，代谢活性增加的肺体积百分比（“%SUV高”）和肺内平均代谢活性（“SUV平均”）与疾病活动的传统生物标志物的相关性明显优于PET二分法和SUVmax。然而，我们提出的量化方法需要后续进行更大规模的研究，不过它可能为未来肺部炎症的定量研究开辟新的可能性，并改善结节病的精准医疗。
