18F-fluorodeoxyglucose-PET/CT imaging of lungs in patients with cystic fibrosis.
BACKGROUND
Airway inflammation plays a critical role in the progression of cystic fibrosis (CF) lung disease, and in the destruction of airways and lung parenchyma. Current methods to assess CF lung disease (BAL, spirometry, and high-resolution CT scanning), do not always accurately reflect actual disease states. Fluorodeoxyglucose (FDG)-PET scanning has been used previously to image infection and inflammation. In this study, we assessed the use of (18)F-FDG PET/CT scanning to evaluate and monitor lung inflammation and/or infection in patients with CF.


METHODS
PET/CT scans were performed in 20 patients with CF (age range, 14 to 54 years); 7 of 20 patients underwent repeat PET/CT scans during and after acute exacerbations. The results were compared with clinical information and with images from eight control subjects with no known lung disease.


RESULTS
Foci of enhanced activity were observed on FDG-PET scans of patients with CF but not those of control subjects. Higher focal activity (standardized uptake value, > 3.0) was seen during disease exacerbation and infection. Coregistered CT scan images assisted in the localization of PET foci and showed corresponding CT scan findings, with many additional findings on CT scans that were not seen on PET scans. Foci seen on high-intensity PET scans during exacerbations disappeared after antibiotic therapy and the resolution of exacerbation, while corresponding CT scan findings remained unchanged.


CONCLUSIONS
PET/CT imaging demonstrated the presence of foci of enhanced uptake that may reflect active focal infectious or inflammatory processes in the lungs. These foci can be cleared with antibiotic therapy. Further studies are needed to validate these results and to determine whether FDG-PET/CT scanning can predict the nature/severity of disease in patients with CF.
Klein
Martine
M
Department of Medical Biophysics and Nuclear Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Cohen-Cymberknoh
Malena
M
Department of Pediatrics and CF Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
Armoni
Shoshana
S
Department of Pediatrics and CF Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
Shoseyov
David
D
Department of Pediatrics and CF Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel.
Chisin
Roland
R
Department of Medical Biophysics and Nuclear Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Orevi
Marina
M
Department of Medical Biophysics and Nuclear Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Freedman
Nanette
N
Department of Medical Biophysics and Nuclear Medicine, Hadassah-Hebrew University Medical Center, Ein Kerem, Jerusalem, Israel.
Kerem
Eitan
E
Department of Pediatrics and CF Center, Hadassah-Hebrew University Medical Center, Mount Scopus, Jerusalem, Israel. Electronic address: kerem@hadassah.org.il.
D000293:Adolescent; D000328:Adult; D003550:Cystic Fibrosis / Q000000981:diagnostic imaging* / Q000503:physiopathology; D018450:Disease Progression; D019788:Fluorodeoxyglucose F18; D005541:Forced Expiratory Volume; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging*; D008875:Middle Aged; D011877:Radionuclide Imaging; D019275:Radiopharmaceuticals; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18