• J. Nucl. Med. · Nov 2014

    18F-FDG kinetics parameters depend on the mechanism of injury in early experimental acute respiratory distress syndrome.

    • Nicolas de Prost, Yan Feng, Tyler Wellman, Mauro R Tucci, Eduardo L Costa, Guido Musch, Tilo Winkler, R Scott Harris, Jose G Venegas, Wei Chao, and Marcos F Vidal Melo.
    • Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts Medical Intensive Care Unit, Hôpital Henri Mondor, Assistance Publique-Hôpitaux de Paris, Créteil, France nicolas.de-prost@hmn.aphp.fr.
    • J. Nucl. Med. 2014 Nov 1;55(11):1871-7.

    UnlabelledPET with (18)F-FDG allows for noninvasive assessment of regional lung metabolism reflective of neutrophilic inflammation. This study aimed at determining during early acute lung injury whether local (18)F-FDG phosphorylation rate and volume of distribution were sensitive to the initial regional inflammatory response and whether they depended on the mechanism of injury: endotoxemia and surfactant depletion.MethodsTwelve sheep underwent homogeneous unilateral surfactant depletion (alveolar lavage) and were mechanically ventilated for 4 h (positive end-expiratory pressure, 10 cm H2O; plateau pressure, 30 cm H2O) while receiving intravenous endotoxin (lipopolysaccharide-positive [LPS+] group; n = 6) or not (lipopolysaccharide-negative group; n = 6). (18)F-FDG PET emission scans were then acquired. (18)F-FDG phosphorylation rate and distribution volume were calculated with a 4-compartment model. Lung tissue expression of inflammatory cytokines was measured using real-time quantitative reverse transcription polymerase chain reaction.Results(18)F-FDG uptake increased in LPS+ (P = 0.012) and in surfactant-depleted sheep (P < 0.001). These increases were topographically heterogeneous, predominantly in dependent lung regions, and without interaction between alveolar lavage and LPS. The increase of (18)F-FDG uptake in the LPS+ group was related both to increases in the (18)F-FDG phosphorylation rate (P < 0.05) and to distribution volume (P < 0.01). (18)F-FDG distribution volume increased with infiltrating neutrophils (P < 0.001) and phosphorylation rate with the regional expression of IL-1β (P = 0.026), IL-8 (P = 0.011), and IL-10 (P = 0.023).ConclusionNoninvasive (18)F-FDG PET-derived parameters represent histologic and gene expression markers of early lung injury. Pulmonary metabolism assessed with (18)F-FDG PET depends on the mechanism of injury and appears to be additive for endotoxemia and surfactant depletion. (18)F-FDG PET may be a valuable imaging biomarker of early lung injury.© 2014 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

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