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Uptake of ¹⁸fluorodeoxyglucose in the cystic fibrosis lung: a measure of lung inflammation?

Depts of ¹ Medicine and ² Nuclear Medicine, McMaster University, ON, Canada

CORRESPONDENCE: M.B. Dolovich, Dept of Nuclear Medicine, McMaster University Medical Centre, 1V16, 1200 Main Street West, Hamilton, ON, L8N 3Z5, Canada. Fax: 1 9055461125. E-mail: mdolovic@mcmaster.ca

Keywords: cystic fibrosis, emission-computed, 18fluorodeoxyglucose, lung, neutrophils, tomography

Received: July 18, 2002
This study was funded by the Canadian Cystic Fibrosis Foundation (SPARX 2).

Positron emission tomography is a three-dimensional imaging technique that measures physiological effects, including metabolism. ¹⁸Fluorodeoxyglucose has been extensively used as a tracer of cellular energy metabolism in the brain and in tumour detection. As neutrophils utilise glucose as an energy source during their respiratory burst, it was hypothesised that ¹⁸fluorodeoxyglucose uptake, by these cells, could be interpreted as a measure of neutrophil activation in cystic fibrosis (CF).

Ten adult CF patients were given a bolus intravenous injection of ¹⁸fluorodeoxyglucose, followed by a 90-min dynamic mid-lung acquisition scan. Right-lung ¹⁸fluorodeoxyglucose uptake was assessed using a Patlak plot and values were converted to glucose utilisation. Three clinically inactive pulmonary sarcoidosis patients served as controls.

From the 10 CF patients with baseline sputum neutrophils of 14x10⁶ cells·mL^–1 who were investigated, seven were found to have sputum at a normal or slightly depressed glucose utilisation rate (mean 1.33 µmol·g^–1·h^–1) compared with a mean of 2.82 µmol·g^–1·h^–1 for the sarcoidosis patients. In eight patients, receiving inhaled tobramycin therapy, no change in lung glucose utilisation or sputum neutrophil counts were found.

Despite high-sputum neutrophil levels, lung glucose utilisation was not elevated in patients with cystic fibrosis.

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