%0 Journal Article %A Vincent Zhang %A Truongan Pham %A Aamir Amanullah %A Mahmoud Aly %A Abhijit Bhattaru %A Mona-Elisabeth Revheim %A Thomas Werner %A Abass Alavi %T Role of 18F-FDG-PET in the Management of Radiation Induced Respiratory Disorders %D 2021 %J Journal of Nuclear Medicine %P 2045-2045 %V 62 %N supplement 1 %X 2045Objectives: Demonstrate the importance of using 18F-FDG-PET to evaluate local and systemic lung effects following radiotherapy of thoracic cancer. Assess the potential application of 18F-FDG-PET in managing radiation induced malignancies, inflammation, and fibrosis in the lung. Methods: 18-fluorodeoxyglucose (FDG) is a glucose analog and positron emitting radio-tracer used for diagnostic purposes. Malignant and inflammatory cells consume high glucose concentrations, thus FDG is a good indicator for detecting such abnormalities. Radiation therapy (RT) is a cancer treatment that is used in both early and advanced stages of local primaries cancer by aiming high energy beams of radiation on cancer cells. However, previous studies have shown that RT may induce incidental inflammation in non-targeted sites which may result in additional negative downstream effects in both cancer and neighboring cells. Cellular damage can lead to chronic inflammation, malignant growth, and fibrous tissue formation. Given this, 18F-FDG-PET can be utilized as a powerful clinical tool to assess the deleterious effects of radiation exposure. This exhibit will examine the ‘before and after’ FDG uptake for RT, specifically focusing on disorders of the lung. Results: Patients are susceptible to radiation induced lung disorders when they are treated with RT for thoracic malignancies (i.e. breast cancer and locally advanced non-small cell lung cancer). Breast cancer RT can induce lung injuries via damage to alveolar and capillary tissue because the lung is located medially relative to the breast within the thoracic cavity, and this may result in inflammation throughout the lung. Acute inflammation and oxidative stress of the lung can lead to three major disorders. Radiation pneumonitis (estimated to occur in up to 50% of lung cancer patients receiving definitive chemoradiation) is a potential short-term problem that can followRT and is due to alveolar inflammation which causes patients to possess shortness of breath and experience a dry cough. Radiation fibrosis may have long term impacts as the consequential inflammation can lead to permanent parenchymal scarring because of poor collagen deposition and vascularity. Therefore it is clinically important to detect radiation pneumonitis at an early stage as patients who are early diagnosed and prompt treated with steroids have a good overall prognosis while they have minimal effect after fibrosis has developed. Indeed, prior research from our lab has established a replicable methodology using the global assessment of standardized uptake values for quantification of post-RT inflammation. Our research has also shown that it is clinically important to use quantitative PET technique to detect radiation pneumonitis at an early stage for a better overall prognosis. Extensive exposure to highly ionized radioactive beams can also damage DNA, inducing the formation of malignancies such as lung cancer. In light of this, increased uptake of FDG not only allows detection of cancerous tissue, but also identifies a curable RT induced inflammation in the lung. Conclusions: RT can lead to the development of radiation pneumonitis, fibrosis of the lung parenchyma and new primary cancers. 18F-FDG is a reliable imaging modality that assesses metabolic uptake and monitors the systemic effects on surrounding organs in patients who have undergone RT. %U