Abstract
Introduction: Neutrophilic inflammation is of pathogenetic importance in COPD but non-invasive clinical assessment is problematic. We assessed the utility of 18FDG PET-CT as a spatially-informative surrogate measure of pulmonary neutrophilic inflammation in COPD.
Methods: 18FDG PET-CT imaging, CT densitometry, clinical and physiological assessment were performed in 10 patients with usual COPD. Regional pulmonary 18FDG uptake was estimated by 3-D Patlak graphical analysis as an indicator of pulmonary neutrophilic glycolytic activity and related to lung physiology and lung density.
Results: 18FDG uptake in the upper lung was greater than in the middle and lower lung regions and correlated with physiological and CT densitometric measures of disease severity (FEV1% predicted, r = -0.848, p = 0.001,; FEV1/FVC, r = -0.918, p < 0.001; Kco% predicted, r = -0.624, p = 0.027; 15th percentile point, r = -0.709, p = 0.011).
Conclusions: The 18FDG signal seen in patients with COPD likely relates to the presence of centrilobular emphysema. The method has a potential role as an imaging biomarker in mechanistic and interventional studies in patients with usual COPD.
- © 2012 ERS