Khandelwal Yogita, Ora Manish, Jain Bela, Dixit Manish, Singh Prakash, Khan Ajmal, Nath Alok, Agarwal Vikas, Gambhir Sanjay
Department of Nuclear Medicine, AIIMS, New Delhi, India.
Department of Nuclear Medicine, SGPGI, Lucknow, India.
Eur J Nucl Med Mol Imaging. 2025 May 13. doi: 10.1007/s00259-025-07297-w.
Post-COVID-19 lung disease (PCLD) is a significant concern following the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic. PCLD encompasses persistent debilitating respiratory symptoms and radiological changes beyond the acute disease phase. It highlights the ongoing search to identify and manage lingering diseases. This prospective study utilizes F18-Fludeoxyglucose (FDG) PET/CT to identify residual inflammatory lung lesions in PCLD. Treatment response was assessed after anti-inflammatory and antifibrotic therapies.
Thirty patients post-severe COVID-19 pneumonia enrolled. They underwent baseline F-FDG PET/CT scans to unveil residual lung inflammation lesions on FDG and CT. They received antifibrotic (Pirfenidone) and anti-inflammatory (Methylprednisolone) drugs for 6-12 weeks. They were followed up for clinical, biochemical, and imaging treatment responses.
Baseline F-FDG PET/CT revealed ongoing lung inflammation in all PCLD (mean SUV: 3.8 ± 2.3 and number of segments: 8±3 ). The mean CT severity score was 17.7 ± 3.4 with moderate (n = 16) or severe (n = 14) disease involvement. Mild, moderate, and severe F-FDG PET/CT categories were noted in the 8, 14, and 8 patients, respectively. Following treatment, a PET scan showed a significant decrease in disease extent (segments) and severity (FDG uptake) and an improvement in disease grading on imaging (97% of patients). In PET concordance, there was a significant clinical and radiological improvement with a fall in inflammatory markers (p < 0.005). Serum Ferritin and total leukocyte counts were significantly associated with PCLD severity on F-FDG PET/CT(p < 0.05).
This prospective study identifies and quantifies ongoing significant residual lung inflammation in PCLD on F-FDG PET/CT. Anti-inflammatory and antifibrotic drug therapy led to clinical and radiological improvement. F-FDG PET/CT as a non-invasive biomarker helped manage and follow up PCLD patients.
Not applicable.
新型冠状病毒肺炎（COVID-19）后肺部疾病（PCLD）是严重急性呼吸综合征冠状病毒2（SARS-CoV-2）大流行后的一个重大问题。PCLD包括急性疾病期过后持续存在的使人衰弱的呼吸道症状和影像学改变。这凸显了对识别和管理迁延性疾病的持续探索。这项前瞻性研究利用F18-氟脱氧葡萄糖（FDG）PET/CT来识别PCLD中残留的肺部炎症性病变。在抗炎和抗纤维化治疗后评估治疗反应。
招募了30例重症COVID-19肺炎康复患者。他们接受了基线F-FDG PET/CT扫描，以发现FDG和CT上残留的肺部炎症性病变。他们接受了6至12周的抗纤维化（吡非尼酮）和抗炎（甲泼尼龙）药物治疗。对他们进行了临床、生化和影像学治疗反应的随访。
基线F-FDG PET/CT显示所有PCLD患者均存在持续的肺部炎症（平均SUV：3.8±2.3，节段数：8±3）。平均CT严重程度评分为17.7±3.4，疾病累及程度为中度（n = 16）或重度（n = 14）。分别在8例、14例和8例患者中观察到轻度、中度和重度F-FDG PET/CT类别。治疗后，PET扫描显示疾病范围（节段）和严重程度（FDG摄取）显著降低，影像学上疾病分级得到改善（97%的患者）。在PET一致性方面，随着炎症标志物的下降，临床和影像学有显著改善（p < 0.005）。血清铁蛋白和白细胞总数与F-FDG PET/CT上的PCLD严重程度显著相关（p < 0.05）。
这项前瞻性研究利用F-FDG PET/CT识别并量化了PCLD中持续存在的显著残留肺部炎症。抗炎和抗纤维化药物治疗导致了临床和影像学改善。F-FDG PET/CT作为一种非侵入性生物标志物有助于管理和随访PCLD患者。
不适用。
