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Journal of Nuclear Medicine Vol. 48 No. 3 413-419
© 2007 by Society of Nuclear Medicine


Basic Science Investigation

PET Imaging of Regional 18F-FDG Uptake and Lung Function After Cigarette Smoke Inhalation

Tobias Schroeder1, Marcos F. Vidal Melo1, Guido Musch1, R. Scott Harris2, Tilo Winkler1 and Jose G. Venegas1

1 Department of Anesthesia and Critical Care, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts; and 2 Pulmonary and Critical Care Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts

Correspondence: For correspondence or reprints contact: Jose G. Venegas, PhD, Massachusetts General Hospital, Department of Anesthesia and Critical Care, CLN 255, 55 Fruit St., Boston, MA 02114. E-mail: jvenegas{at}vqpet.mgh.harvard.edu

Cigarette smoke is thought to promote local lung inflammation that leads to lung dysfunction. Lung neutrophilic inflammation is known to result in increased pulmonary uptake of 18F-FDG. Using a sheep model of localized exposure to cigarette smoke, in this study we tested whether PET-imaged changes in regional intrapulmonary distribution of 18F-FDG uptake are related to changes in regional lung function as assessed with the infused 13NN-saline method. Methods: Five anesthetized, mechanically ventilated sheep were exposed to unilateral inhalation of smoke from 10 tobacco cigarettes while the contralateral lung was ventilated with smoke-free gas. Two hours after the exposure, regional gas content was measured from a transmission scan; regional ventilation, perfusion, and shunt were measured from the kinetics of 13NN-saline; and regional 18F-FDG influx constant (Ki) was calculated with the Patlak algorithm applied at a voxel-by-voxel level. Results: Ki was higher and more heterogeneous in the smoke-exposed lungs than in the control lungs (P < 0.05). Spatial heterogeneity of Ki and impairment in regional lung function were quite variable among animals despite similar levels of smoke exposure. However, increases in mean Ki correlated linearly with its spatial heterogeneity (Spearman correlation, rs = 0.94), and the highest levels of regional Ki in smoke-exposed lungs and control lungs correlated with regional shunt fraction (rs = 0.78). Also, the heterogeneity of the ventilation–perfusion (Formula) distribution of the smoke-exposed lungs was 10 times greater than that of the control lungs but correlated strongly with that of the control lungs (r = 0.998). Conclusion: Substantial interanimal variability and spatial heterogeneity in lung function and 18F-FDG uptake seem to characterize the response to smoke exposure. The highest levels of local 18F-FDG uptake were associated with differences in Formula matching and shunt fraction among animals. The data also suggest that preexisting heterogeneity in Formula could have been responsible for the large interanimal variability by affecting the heterogeneity and strength of the acute response to smoke inhalation.

Key Words: positron emission tomography • FDG • pulmonary gas exchange • inflammation • smoke inhalation injury

COPYRIGHT © 2007 by the Society of Nuclear Medicine, Inc.


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T. Schroeder, M. F. Vidal Melo, G. Musch, R. S. Harris, J. G. Venegas, and T. Winkler
Image-Derived Input Function for Assessment of 18F-FDG Uptake by the Inflamed Lung
J. Nucl. Med., November 1, 2007; 48(11): 1889 - 1896.
[Abstract] [Full Text] [PDF]




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