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Comparison of Methods to Quantitate ¹⁸F-FDG Uptake with PET During Experimental Acute Lung Injury

¹ Department of Radiology, Washington University School of Medicine, St. Louis, Missouri
² Department of Surgery, Washington University School of Medicine, St. Louis, Missouri
³ Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri

PET with ¹⁸F-FDG may be useful for quantifying neutrophilic activation. We previously demonstrated that pulmonary neutrophil sequestration could be detected during acute lung injury (ALI), even without migration into the alveolar compartment. Using the influx constant K_i as the method to quantify lung ¹⁸F-FDG uptake, we also showed that K_i correlated positively with in vitro assays of ³H-deoxyglucose (³H-DG) uptake in cells harvested via bronchoalveolar lavage. In the present study, we have reanalyzed data from that study to determine if simpler nonkinetic methods of quantifying the pulmonary uptake of ¹⁸F-FDG could be as powerful as calculating K_i. Methods: ¹⁸F-FDG uptake was quantified as K_i, calculated by 3-compartmental model analysis (used as the gold standard) and Patlak graphical analysis, with and without normalization for initial volume of tracer distribution; the standardized uptake value; and the tissue-to-plasma activity ratio (TPR). Results: Values for K_i, determined either from a 3-compartmental model analysis of the time–activity data or by Patlak graphical analysis, were highly correlated (R² = 0.97). The correlation was worse if these variables were normalized for the initial volume of tracer distribution. TPR was highly correlated with K_i determined by the compartmental model (R² = 0.96) and with in vitro measurements of ³H-DG uptake (R² = 0.63). Conclusion: The TPR is a simple and equally effective alternative to dynamic imaging in determining net ¹⁸F-FDG uptake during ALI. Normalization of the kinetic data for differences in the initial volume of tracer distribution does not contribute significantly to signal interpretation during ALI.

Key Words: FDG • compartmental model • acute lung injury • inflammation imaging • PET

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