Introduction: To investigate the combined performance of quantitative CT (qCT) following a computer algorithm analysis (IMBIO) and F-FDG PET/CT to assess survival in patients with idiopathic pulmonary fibrosis (IPF).
Methods: A total of 113 IPF patients (age 70 ± 9 years) prospectively and consecutively underwent F-FDG PET/CT and high-resolution CT (HRCT) at our institution. During a mean follow-up of 29.6 ± 26 months, 44 (48%) patients died. As part of the qCT analysis, pattern evaluation of HRCT (using IMBIO software) included the total extent (percentage) of the following features: normal-appearing lung, hyperlucent lung, parenchymal damage (comprising ground-glass opacification, reticular pattern and honeycombing), and the pulmonary vessels. The maximum (SUV) and minimum (SUV) standardized uptake value (SUV) for F-FDG uptake in the lungs, and the target-to-background (SUV/SUV) ratio (TBR) were quantified using routine region-of-interest (ROI) analysis. Pulmonary functional tests (PFTs) were acquired within 14 days of the PET/CT/HRCT scan. Kaplan-Meier (KM) survival analysis was used to identify associations with mortality.
Results: Data from 91 patients were available for comparative analysis. The average ± SD GAP [gender, age, physiology] score was 4.2 ± 1.7 (range 0-8). The average ± SD SUV, SUV, and TBR were 3.4 ± 1.4, 0.7 ± 0.2, and 5.6 ± 2.8, respectively. In all patients, qCT analysis demonstrated a predominantly reticular lung pattern (14.9 ± 12.4%). KM analysis showed that TBR (p = 0.018) and parenchymal damage assessed by qCT (p = 0.0002) were the best predictors of survival. Adding TBR and qCT to the GAP score significantly increased the ability to differentiate between high and low risk (p < 0.0001).
Conclusion: F-FDG PET and qCT are independent and synergistic in predicting mortality in patients with IPF.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6667685 | PMC |
http://dx.doi.org/10.1007/s00259-019-04386-5 | DOI Listing |
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