Paul Flechsig1,2,3, Olena Hural3, Michael Kreuter2,4, Martin Eichhorn2,5, Gudula HEUßEL2,3,5, Christos Sachpekidis6,7, Hans-Ulrich Kauczor2,8, Uwe Haberkorn6,2,7, Claus Peter Heussel2,3, Monika Eichinger2,3. 1. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany paul.flechsig@med.uni-heidelberg.de. 2. Translational Lung Research Center Heidelberg, Member of the German Center for Lung Research DZL, Heidelberg, Germany. 3. Division of Diagnostic and Interventional Radiology with Nuclear Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany. 4. Centre for Interstitial and Rare Lung Diseases, Pneumology and Respiratory Critical Care Medicine, Thorax Clinic, University of Heidelberg, Heidelberg, Germany. 5. Department of Thoracic Surgery, Thorax Clinic, University of Heidelberg, Heidelberg, Germany. 6. Department of Nuclear Medicine, University Hospital Heidelberg, Heidelberg, Germany. 7. Clinical Cooperation Unit, Department of Nuclear Medicine, German Cancer Research Center (DKFZ), Heidelberg, Germany. 8. Department of Diagnostic and Interventional Radiology, University Hospital Heidelberg, Heidelberg, Germany.
Abstract
BACKGROUND/AIM: Idiopathic pulmonary fibrosis IPF is a type of interstitial lung disease (ILD) with poor prognosis. Lung cancer (LC) is a frequent complication in IPF, where all therapeutic options are potential triggers for acute exacerbation of IPF. PATIENTS AND METHODS: Patients with 2-deoxy-2-fluoro-D-glucose-positron emission tomography/computer tomography (FDG-PET/CT) results before lobectomy for LC with and without (n=10 each) signs of ILD in initial imaging and after-care CT were retrospectively analyzed. FDG uptake was calculated as the maximum standardized uptake value (SUVmax) in the lung periphery divided by the SUVmax of the mediastinal blood pool (rSUVmax). Regional increase of fibrosis and ground-glass features in lobe-based CT analysis was used as standard reference. RESULTS: Patients with LC with ILD presented a significantly higher rSUVmax of 0.57 compared to patients without ILD with rSUVmax 0.47 (p<0.001). CONCLUSION: rSUVmax seems to be a valuable imaging surrogate in predicting patients with LC with increased risk for progressive ILD associated with thoracic surgery. Copyright
BACKGROUND/AIM: Idiopathic pulmonary fibrosis IPF is a type of interstitial lung disease (ILD) with poor prognosis. Lung cancer (LC) is a frequent complication in IPF, where all therapeutic options are potential triggers for acute exacerbation of IPF. PATIENTS AND METHODS: Patients with 2-deoxy-2-fluoro-D-glucose-positron emission tomography/computer tomography (FDG-PET/CT) results before lobectomy for LC with and without (n=10 each) signs of ILD in initial imaging and after-care CT were retrospectively analyzed. FDG uptake was calculated as the maximum standardized uptake value (SUVmax) in the lung periphery divided by the SUVmax of the mediastinal blood pool (rSUVmax). Regional increase of fibrosis and ground-glass features in lobe-based CT analysis was used as standard reference. RESULTS:Patients with LC with ILD presented a significantly higher rSUVmax of 0.57 compared to patients without ILD with rSUVmax 0.47 (p<0.001). CONCLUSION:rSUVmax seems to be a valuable imaging surrogate in predicting patients with LC with increased risk for progressive ILD associated with thoracic surgery. Copyright
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