Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Department of Nuclear Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
J Korean Med Sci. 2021 Oct 25;36(41):e257. doi: 10.3346/jkms.2021.36.e257.
Several parameters are useful for assessing disease severity in idiopathic pulmonary fibrosis (IPF); however, the role of F-fluorodeoxyglucose positron emission tomography/computed tomography (F-FDG PET/CT) is not well-defined. We aimed to evaluate the value of F-FDG PET/CT for assessing disease severity and prognosis in IPF patients.
Clinical data of 89 IPF patients (mean age: 68.1 years, male: 94%) who underwent F-FDG PET/CT for evaluation of lung nodules or cancer staging were retrospectively reviewed. Mean and maximal standardized uptake values (SUV, SUV, respectively) were measured in the fibrotic area. Adjusted SUV, including SUV ratio (SUVR, defined as SUV-to-liver SUV ratio), tissue fraction-corrected SUV (SUV), and SUVR (SUVR), and tissue-to-blood ratio (SUV/SUV venous; TBR) were obtained. Death was defined as the primary outcome, and associations between other clinical parameters (lung function, exercise capacity, C-reactive protein [CRP] level) were also investigated.
All SUV parameters were inversely correlated with the forced vital capacity, diffusing capacity for carbon monoxide, and positively correlated with CRP level and the gender-age-physiology index. The SUV, SUV, and SUV were associated with changes in lung function at six months. The SUVR (hazard ratio [HR], 1.738; 95% confidence interval [CI], 1.011-2.991), SUVR (HR, 1.441; 95% CI, 1.000-2.098), and TBR (HR, 1.377; 95% CI, 1.038-1.827) were significant predictors for mortality in patients with IPF in the univariate analysis, but not in the multivariate analysis.
F-FDG PET/CT may provide additional information on the disease severity and prognosis in IPF patients, and the SUVR may be superior to other SUV parameters.
评估特发性肺纤维化（IPF）疾病严重程度时，有多个参数可用；然而，氟-18 氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（F-FDG PET/CT）的作用尚未明确。我们旨在评估 F-FDG PET/CT 评估 IPF 患者疾病严重程度和预后的价值。
回顾性分析了 89 例因肺结节或癌症分期而行 F-FDG PET/CT 评估的 IPF 患者的临床资料（平均年龄：68.1 岁，男性：94%）。在纤维化区域测量平均和最大标准化摄取值（SUV、SUV ，分别）。获得调整后的 SUV，包括 SUV 比（SUVR，定义为 SUV 与肝 SUV 比）、组织分数校正 SUV（SUV ）和 SUVR（SUV ）以及组织与血液比（SUV/SUV 静脉；TBR）。死亡定义为主要结局，还研究了其他临床参数（肺功能、运动能力、C 反应蛋白 [CRP] 水平）之间的关联。
所有 SUV 参数均与用力肺活量、一氧化碳弥散量呈负相关，与 CRP 水平和性别-年龄-生理指数呈正相关。SUV、SUV 和 SUV 与 6 个月时肺功能变化相关。SUVR（风险比 [HR]，1.738；95%置信区间 [CI]，1.011-2.991）、SUVR（HR，1.441；95% CI，1.000-2.098）和 TBR（HR，1.377；95% CI，1.038-1.827）是单变量分析中 IPF 患者死亡的显著预测因子，但在多变量分析中并非如此。
F-FDG PET/CT 可能为 IPF 患者的疾病严重程度和预后提供额外信息，而 SUVR 可能优于其他 SUV 参数。
