AI Article Synopsis
- Patients with chronic respiratory diseases show increased respiratory muscle activity, and this study explored the relationship between respiratory muscle metabolism and lung function impairment in lung cancer surgery patients using F-FDG-PET/CT scans.
- The study included 156 patients, revealing that certain respiratory muscles exhibited hypermetabolism, which correlated with impaired lung function and overall survival outcomes.
- The results suggest that assessing respiratory muscle activity using F-FDG-PET/CT could provide important prognostic information for patients undergoing lung cancer surgery.
Article Abstract
Background And Objective: Respiratory muscle activity is increased in patients with chronic respiratory disease. F-FDG-PET/CT can assess respiratory muscle activity. We hypothesized that respiratory muscles metabolism was correlated to lung function impairment and was associated to prognosis in patients undergoing lung cancer surgery based on the research question whether respiratory muscle metabolism quantitatively correlates with the severity of lung function impairment in patients? Does respiratory muscle hypermetabolism have prognostic value?
Methods: Patients undergoing F-FDG-PET/CT and pulmonary function tests prior to lung cancer surgery were identified. Maximum Standardized Uptake Value (SUVm) were measured in each respiratory muscle group (sternocleidomastoid, scalene, intercostal, diaphragm), normalized against deltoid SUVm. Respiratory muscle hypermetabolism was defined as SUVm >90th centile in any respiratory muscle group. Clinical outcomes were collected from a prospective cohort.
Results: One hundred fifty-six patients were included, mostly male [110 (71%)], 53 (34%) with previous diagnosis of COPD. Respiratory muscle SUVm were: scalene: 1.84 [1.51-2.25], sternocleidomastoid 1.64 [1.34-1.95], intercostal 1.01 [0.84-1.16], diaphragm 1.79 [1.41-2.27]. Tracer uptake was inversely correlated to FEV1 for the scalene (r = -0.29, p < 0.001) and SCM (r = -0.17, p = 0.03) respiratory muscle groups and positively correlated to TLC for the scalene (r = 0.17, p = 0.04). Respiratory muscle hypermetabolism was found in 45 patients (28.8%), who had a lower VO max (15.4 [14.2-17.5] vs. 17.2 mL/kg/min [15.2-21.1], p = 0.07) and poorer overall survival when adjusting to FEV1% (p < 0.01).
Conclusion: Our findings show respiratory muscle hypermetabolism is associated with lung function impairment and has prognostic significance. F-FDG/PET-CT should be considered as a tool for assessing respiratory muscle activity and to identify high-risk patients.
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| http://dx.doi.org/10.1111/resp.14475 | DOI Listing |
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