Neutrophilic inflammation plays a key role in the pathogenesis of acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Positron emission tomography (PET) with [F]-fluoro-2-deoxy-D-glucose (FDG) can be used to image cellular metabolism that, during lung inflammatory processes, likely reflects neutrophils activity. The aim of this study was to assess the magnitude and regional distribution of inflammatory metabolic activity in the lungs of patients with ALI/ARDS by PET with FDG. Fifteen patients with ALI/ARDS were enrolled, while four spontaneously breathing and two mechanically ventilated subjects, without known lung disease, served as controls. In each individual we performed an FDG PET/computed tomography of the thorax. FDG cellular influx rate constant (Ki) was computed for the imaged lung field and for regions of interest, grouping voxels with similar density. In all patients with ALI/ARDS, Ki was higher than in controls, also after accounting for the increased lung density. Ki values differed greatly among patients, but in all patients Ki of the normally aerated regions was much higher (2- to 24-fold) than in controls. Whereas in some patients the highest Ki values corresponded to regions with the lowest aeration, in others these regions had lower Ki than normally and mildly hypoaerated regions. In patients with ALI/ARDS, undergoing mechanical ventilation since days, the metabolic activity of the lungs is markedly increased across the entire lung density spectrum. The intensity of this activation and its regional distribution, however, vary widely within and between patients.

(2010). Imaging of lung metabolic activity by means of positron emission tomography during acute lung injury. (Tesi di dottorato, Università degli Studi di Milano-Bicocca, 2010).

Imaging of lung metabolic activity by means of positron emission tomography during acute lung injury

BELLANI, GIACOMO
2010-01-21

Abstract

Neutrophilic inflammation plays a key role in the pathogenesis of acute respiratory distress syndrome (ARDS) and acute lung injury (ALI). Positron emission tomography (PET) with [F]-fluoro-2-deoxy-D-glucose (FDG) can be used to image cellular metabolism that, during lung inflammatory processes, likely reflects neutrophils activity. The aim of this study was to assess the magnitude and regional distribution of inflammatory metabolic activity in the lungs of patients with ALI/ARDS by PET with FDG. Fifteen patients with ALI/ARDS were enrolled, while four spontaneously breathing and two mechanically ventilated subjects, without known lung disease, served as controls. In each individual we performed an FDG PET/computed tomography of the thorax. FDG cellular influx rate constant (Ki) was computed for the imaged lung field and for regions of interest, grouping voxels with similar density. In all patients with ALI/ARDS, Ki was higher than in controls, also after accounting for the increased lung density. Ki values differed greatly among patients, but in all patients Ki of the normally aerated regions was much higher (2- to 24-fold) than in controls. Whereas in some patients the highest Ki values corresponded to regions with the lowest aeration, in others these regions had lower Ki than normally and mildly hypoaerated regions. In patients with ALI/ARDS, undergoing mechanical ventilation since days, the metabolic activity of the lungs is markedly increased across the entire lung density spectrum. The intensity of this activation and its regional distribution, however, vary widely within and between patients.
MESSA, MARIA CRISTINA
Acute Lung Injury; Acute Respiratry Distress Syndrome; Positron Emission Tomography
MED/36 - DIAGNOSTICA PER IMMAGINI E RADIOTERAPIA
English
Scuola di Dottorato in Scienze Mediche Sperimentali e Cliniche
TECNOLOGIE BIOMEDICHE - 20R
22
2008/2009
(2010). Imaging of lung metabolic activity by means of positron emission tomography during acute lung injury. (Tesi di dottorato, Università degli Studi di Milano-Bicocca, 2010).
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/7887
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