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Research ArticlePulmonary

PET Imaging Reveals Early Pulmonary Perfusion Abnormalities in HIV Infection Similar to Smoking

Puja Kohli, Vanessa J. Kelly, Kathryn A. Hibbert, Björn Corleis, Mamary Kone, Josalyn L. Cho, Doreen DeFaria-Yeh, Douglas S. Kwon, Benjamin D. Medoff, R. Scott Harris and Tilo Winkler
Journal of Nuclear Medicine March 2021, 62 (3) 405-411; DOI: https://doi.org/10.2967/jnumed.120.245977
Puja Kohli
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
2Department of Medicine, Harvard Medical School, Boston, Massachusetts
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Vanessa J. Kelly
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
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Kathryn A. Hibbert
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
2Department of Medicine, Harvard Medical School, Boston, Massachusetts
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Björn Corleis
3The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts
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Mamary Kone
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
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Josalyn L. Cho
4Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Doreen DeFaria-Yeh
2Department of Medicine, Harvard Medical School, Boston, Massachusetts
5Division of Cardiology, Massachusetts General Hospital, Boston, Massachusetts
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Douglas S. Kwon
2Department of Medicine, Harvard Medical School, Boston, Massachusetts
3The Ragon Institute of MGH, MIT and Harvard, Cambridge, Massachusetts
6Division of Infectious Disease, Massachusetts General Hospital, Boston, Massachusetts; and
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Benjamin D. Medoff
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
2Department of Medicine, Harvard Medical School, Boston, Massachusetts
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R. Scott Harris
1Division of Pulmonary and Critical Care at Massachusetts General Hospital, Boston, Massachusetts
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Tilo Winkler
7Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, Massachusetts
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Abstract

Chronic obstructive pulmonary disease (COPD) is the most common noninfectious pulmonary disease among people living with HIV, independent of smoking. However, the cause for this enhanced susceptibility remains unclear, and the effects of HIV on pulmonary perfusion and ventilation are unknown. Methods: We used PET/CT in 46 smokers and nonsmokers, 23 of whom had documented HIV infection. Emphysema was assessed by CT and perfusion by 13N (13NN) PET scans. After removal of image noise, vertical and axial gradients in perfusion were calculated. We tested for differences in the total spatial heterogeneity of perfusion (CV2Qtotal) and its components (CV2Qtotal = CV2Qvgrad [vertical gradient] + CV2Qzgrad [axial gradient] + CV2Qr [residual heterogeneity]) among groups. Results: There were no significant differences in demographic parameters among groups, and all subjects had minimal radiographic evidence of emphysema. Compared with controls, nonsmokers living with HIV had a significantly greater CV2Qr/CV2Qtotal (0.48 vs. 0.36, P = 0.05) and reduced CV2Qvgrad/CV2Qtotal (0.46 vs. 0.65, P = 0.038). Smokers also had a reduced CV2Qvgrad/CV2Qtotal, however, there was no significant difference in CV2Qvgrad/CV2Qtotal between smokers living with and without HIV (0.39 vs. 0.34, P = 0.58), despite a decreased vertical perfusion gradient (Qvgrad) in smokers living with HIV. Conclusion: In nonsmokers living with well-controlled HIV and minimal radiographic emphysema, HIV infection contributes to pulmonary perfusion abnormalities similar to smokers. These data indicate the onset of subclinical pulmonary perfusion abnormalities that could herald the development of significant lung disease in these susceptible individuals.

  • vascular
  • HIV
  • PET/CT
  • pulmonary perfusion
  • pulmonary vascular disease

Footnotes

  • Published online Aug. 6, 2020.

  • © 2021 by the Society of Nuclear Medicine and Molecular Imaging.
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Journal of Nuclear Medicine: 62 (3)
Journal of Nuclear Medicine
Vol. 62, Issue 3
March 1, 2021
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PET Imaging Reveals Early Pulmonary Perfusion Abnormalities in HIV Infection Similar to Smoking
Puja Kohli, Vanessa J. Kelly, Kathryn A. Hibbert, Björn Corleis, Mamary Kone, Josalyn L. Cho, Doreen DeFaria-Yeh, Douglas S. Kwon, Benjamin D. Medoff, R. Scott Harris, Tilo Winkler
Journal of Nuclear Medicine Mar 2021, 62 (3) 405-411; DOI: 10.2967/jnumed.120.245977

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PET Imaging Reveals Early Pulmonary Perfusion Abnormalities in HIV Infection Similar to Smoking
Puja Kohli, Vanessa J. Kelly, Kathryn A. Hibbert, Björn Corleis, Mamary Kone, Josalyn L. Cho, Doreen DeFaria-Yeh, Douglas S. Kwon, Benjamin D. Medoff, R. Scott Harris, Tilo Winkler
Journal of Nuclear Medicine Mar 2021, 62 (3) 405-411; DOI: 10.2967/jnumed.120.245977
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Keywords

  • vascular
  • HIV
  • PET/CT
  • pulmonary perfusion
  • pulmonary vascular disease
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