title: FDG-PET/CT in the prediction of pulmonary function improvement in nonspecific interstitial pneumonia. A Pilot Study.
abstract: OBJECTIVE
  Our study aimed to analyse the characteristics of nonspecific interstitial pneumonia (NSIP) using FDG-PET/CT (PET) and to evaluate its ability to predict the therapeutic response.
  
  
  METHODS
  Eighteen NSIP patients were included. Maximum standardized uptake value (SUVmax), FDG uptake extent (in percentage of lung volume), high resolution CT scan (HRCT) elementary lesions, and HRCT fibrosis score were recorded. The predictive value of the parameters for lung function improvement was evaluated using logistic regression and Receiver Operating Characteristic (ROC) curve analysis (n=13/18).
  
  
  RESULTS
  All patients had an increased pulmonary FDG uptake (median SUVmax=3.1 [2-7.6]), with a median extent of 19% [6-67]. Consolidations, ground-glass opacities, honeycombing and reticulations showed uptake in 90%, 89%, 85% and 76%, respectively. FDG uptake extent was associated with improvement of pulmonary function under treatment (increase in forced vital capacity>10%, p=0.03), whereas SUVmaxand HRCT fibrosis score were not (p>0.5). For FDG uptake extent, ROC analysis showed an area under the curve at 0.85±0.11 and sensitivity/specificity was 88%/80% for a threshold fixed at 21%.
  
  
  CONCLUSIONS
  Increased FDG uptake was observed in all NSIP patients, both in inflammatory and fibrotic HRCT lesions. The quantification of FDG uptake extent might be useful to predict functional improvement under treatment.
authors.affiliation: AP-HP, Hosp. Avicenne, Department of Nuclear Medicine, Bobigny, France.
authors.forename: V
authors.initials: V
authors.lastname: Jacquelin
authors.affiliation: AP-HP, Hosp. Saint-Antoine, Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Mekinian
authors.affiliation: AP-HP, Hosp. Avicenne, Department of Radiology, Bobigny, France; Univ. Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors.forename: P Y
authors.initials: PY
authors.lastname: Brillet
authors.affiliation: AP-HP, Hosp. Avicenne, Department of Pneumology, Bobigny, France; Univ. Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors.forename: H
authors.initials: H
authors.lastname: Nunes
authors.affiliation: AP-HP, Hosp. Saint-Antoine, Department of Internal Medicine and Inflammation-Immunopathology-Biotherapy Department (DHU i2B), Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Fain
authors.affiliation: AP-HP, Hosp. Avicenne, Department of Pneumology, Bobigny, France; Univ. Paris 13, Sorbonne Paris Cité, Bobigny, France.
authors.forename: D
authors.initials: D
authors.lastname: Valeyre
authors.affiliation: AP-HP, Hosp. Avicenne, Department of Nuclear Medicine, Bobigny, France; Univ. Paris 13, Sorbonne Paris Cité, Bobigny, France. Electronic address: michael.soussan@aphp.fr.
authors.forename: M
authors.initials: M
authors.lastname: Soussan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D005260:Female; D019788:Fluorodeoxyglucose F18; D005500:Follow-Up Studies; D005541:Forced Expiratory Volume / Q000502:physiology; D005544:Forecasting; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D017563:Lung Diseases, Interstitial / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods*; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging; D012372:ROC Curve; D011856:Radiographic Image Enhancement / Q000379:methods; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods; D014109:Total Lung Capacity / Q000502:physiology; D016896:Treatment Outcome; D014797:Vital Capacity / Q000502:physiology
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: 18F-FDG; Idiopathic interstitial pneumonia; Interstitial; Lung diseases; Positron-emission tomography; Treatment outcome