Document Detail


Lungs of patients with acute respiratory distress syndrome show diffuse inflammation in normally aerated regions: a [18F]-fluoro-2-deoxy-D-glucose PET/CT study.
MedLine Citation:
PMID:  19487931     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: 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. DESIGN: Prospective clinical investigation. PATIENTS: Ten patients with ALI/ARDS; four spontaneously breathing and two mechanically ventilated subjects, without known lung disease, served as controls. INTERVENTIONS: In each individual we performed an FDG PET/computed tomography of the thorax. MEASUREMENTS AND MAIN RESULTS: 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. CONCLUSION: 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.
Authors:
Giacomo Bellani; Cristina Messa; Luca Guerra; Ester Spagnolli; Giuseppe Foti; Nicolò Patroniti; Roberto Fumagalli; Guido Musch; Ferruccio Fazio; Antonio Pesenti
Publication Detail:
Type:  Controlled Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Critical care medicine     Volume:  37     ISSN:  1530-0293     ISO Abbreviation:  Crit. Care Med.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-06-18     Completed Date:  2009-07-07     Revised Date:  2009-12-29    
Medline Journal Info:
Nlm Unique ID:  0355501     Medline TA:  Crit Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2216-22     Citation Subset:  AIM; IM    
Affiliation:
Department of Experimental Medicine, 'Centro Bioimmagini Molecolari', University of Milan-Bicocca, Monza (MI), Italy.
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MeSH Terms
Descriptor/Qualifier:
Acute Lung Injury / diagnosis*,  metabolism,  therapy
Aged
Female
Fluorodeoxyglucose F18 / diagnostic use
Humans
Intensive Care
Male
Middle Aged
Neutrophil Activation / physiology
Positron-Emission Tomography*
Predictive Value of Tests
Radiopharmaceuticals / diagnostic use
Respiration, Artificial
Respiratory Distress Syndrome, Adult / diagnosis*,  metabolism,  therapy
Respiratory Function Tests
Tomography, X-Ray Computed*
Chemical
Reg. No./Substance:
0/Radiopharmaceuticals; 63503-12-8/Fluorodeoxyglucose F18
Comments/Corrections
Comment In:
Crit Care Med. 2010 Jan;38(1):347-8; author reply 348   [PMID:  20023508 ]

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