Presurgical heterogeneity of lung ¹⁸FDG-PET uptake predicts acute exacerbation of interstitial lung disease following pulmonary resection in patients with smoke exposures

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Author Info

Yuko Oya Hiroaki Kuroda Hiroshi Iwata Keita Nakanishi Noriaki Sakakura Toyoaki Hida Yukinori Sakao Yusuke Sugita Yusuke Takahashi

Corresponding Author

Hiroaki Kuroda
Department of Thoracic Surgery, Aichi Cancer Center

A B S T R A C T

Objectives: Acute exacerbation of interstitial lung disease (AEILD) is a severe complication after pulmonary resection. This study investigates whether 2-[18]-fluoro-2-deoxy-D-glucose (18F-FDG) uptake on positron emission tomography (PET) in ILD areas is a predictor of AEILD. Methods: We enrolled 200 non-small cell lung cancer (NSCLC) patients with smoke exposures. Ten (5.0%) developed AEILD of whom seven were diagnosed as severe AEILD requiring medication. Patients were classified into either heterogeneity (HET, presence of ILD and non-ILD areas) or homogeneity (HOM, only non-ILD) according to the 18F-FDG uptake at diaphragm level. Results: The average maximum 18F-FDG uptake by NSCLC and in non-ILD was in HOM comparable to that in HET (p = 0.86 and p = 0.14, respectively); however; it was 2.8-fold higher in ILD than in non-ILD within HET (p < 0.01). Multivariate analyses revealed that only HET was independent factors for AEILD and severe AEILD (p < 0.01, and p = 0.03, respectively). Among HET, honeycombing or a triad of reticulation, consolidation, and ground-glass attenuation on high-resolution computed tomography (n = 21) associated with higher complication rate regarding AEILD and worse prognosis (both p < 0.01). Conclusions: Presurgical 18F-FDG uptake on normal lung areas may predict AEILD in smoke exposures. Synopsis: Heterogeneity consisted of normal lung area and interstitial lung disease area according to 18FFDG uptake. The average maximum 18F-FDG uptake was 2.8-fold higher in interstitial lung area than in normal area within heterogeneity. honeycombing or plenty of distinctive findings of interstitial lung disease on high-resolution computed tomography associated with higher complication rate regarding acute exacerbation of interstitial lung disease and worse prognosis.

Article Info

Article Type

Research Article

Publication history

Received: Tue 28, May 2019
Accepted: Thu 13, Jun 2019
Published: Tue 09, Jul 2019

Copyright

© 2023 Hiroaki Kuroda. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2019.02.08