18F-FDG positron emission tomography scanning in systemic sclerosis-associated interstitial lung disease: a pilot study

Abstract

Background Interstitial lung disease is a common complication of systemic sclerosis (SSc-ILD), and it remains difficult to accurately predict its course. Progressing ILD could be more metabolically active, suggesting that the 18F-FDG tracer could be a tool in the managing of SSc-ILD. Methods In our center, SSc patients and controls (non-Hodgkin lymphoma cured after first-line regimen) who had received a PET/CT were screened retrospectively. The FDG uptake (visual intensity, pattern, SUVmax) was systematically recorded in > 30 regions of interest (ROIs) linked to SSc in a blind reviewing by 2 independent nuclear medicine physicians using a standardized form. Results Among the 545 SSc patients followed up in our center, 36, including 22 SSc-ILDs, had a PET/CT, whose indication was cancer screening in most cases. The mean ± SD age was 57.9 ± 13.0 years with 20/36 females. Fourteen patients had a disease duration of less than 2 years. A third had anti-centromere antibodies and 27.8% had anti-topoisomerase antibodies. Pulmonary FDG uptakes were higher in SSc patients than in controls (n = 89), especially in those with ILD compared with those without ILD. Pulmonary FDG uptakes were positively correlated with the ILD severity (fibrosis extent, %FVC, and %DLCO). No significant difference was found in the FDG uptakes from extrathoracic ROIs. Progressing SSc-ILDs within the 2 years after PET/CT (n = 9) had significant higher pulmonary FDG uptakes at baseline than stable SSc-ILDs (n = 13). Conclusion PET/CT could be a useful tool in the assessment of the severity and the prediction of pulmonary function outcome of SSc-ILD.

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

“…In Ssc-ILD patients, pulmonary FDG uptake was correlated with ILD severity [14]. Together with abnormal mediastinal/hilar lymph node, it was as well identi ed to be associated with progression of ILD within two years [14]. The predictive value of pulmonary FDG uptake for ILD progression crossed the boundary of IPF, tumor-associated ILD and CTD-ILD, and deserves to be further veri ed in more ILD spectrum and larger cohort.…”

“…[8][9][10][11] Since elevated 18 F-uorodeoxyglucose (FDG) uptake in PET/CT scan was capable of revealing focal immune activation, a series of studies have focused on the clinical value of PET/CT scan in these diseases. In systemic-sclerosis-related ILD (SSc-ILD), pulmonary FDG uptake was signi cantly increased and correlated with severity of ILD [13,14]. Besides, elevation of pulmonary FDG uptake also predicted progression of SSc-ILD [14].…”

“…In systemic-sclerosis-related ILD (SSc-ILD), pulmonary FDG uptake was signi cantly increased and correlated with severity of ILD [13,14]. Besides, elevation of pulmonary FDG uptake also predicted progression of SSc-ILD [14]. In IIM-ILD, Dr Morita rst reported an IIM-ILD patient who presented high pulmonary FDG uptake and subsequently died of RP-ILD [15].…”

The lungs were on fire: a pilot study of 18F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

“…Since elevated 18 F-fluorodeoxyglucose (FDG) uptake on PET/CT scans can indicate focal immune activation, a series of studies have focused on the clinical value of PET/CT scans in these diseases. In systemic sclerosis-related ILD (SSc-ILD), pulmonary FDG uptake was significantly increased and correlated with the severity of ILD [12,13]. In addition, elevated pulmonary FDG uptake also predicted the progression of SSc-ILD [13].…”

“…In systemic sclerosis-related ILD (SSc-ILD), pulmonary FDG uptake was significantly increased and correlated with the severity of ILD [12,13]. In addition, elevated pulmonary FDG uptake also predicted the progression of SSc-ILD [13]. Dr Morita reported an IIM-ILD patient who presented with high pulmonary FDG uptake and subsequently died of RP-ILD [14].…”