PDF(Pubmed)
Abstract：
The clinical value of 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) in assessing relapsing polychondritis (RP) with airway involvement remains controversial. This study aimed to investigate PET/CT features of RP with airway involvement and explore its clinical value in predicting disease pattern, severity and prognosis.
RP patients with airway involvement who underwent PET/CT from January 2010 to July 2022 were retrospectively reviewed. PET/CT features were analyzed both visually and semiquantitatively with the maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG). Patterns of airway involvement on PET were summarized. Correlations of SUVmax and TLG of the airway were made with spirometric indicators and serological inflammatory markers (CRP and ESR). In addition, long-term follow-up was conducted through questionnaires in regard to symptom control, subjective feeling, pulmonary function, and quality of life.
Fifty-two cases were finally included. 18F-FDG PET showed FDG-avid lesions with increased FDG uptake in the airway among 94.2% of the patients. Three patterns (focal, multifocal and diffuse patterns) were identified. TLG of the whole airway was lower in patients with previous therapy (p = 0.046). Bronchoscopy was more sensitive in detecting tracheal abnormalities (90.7% vs.53.5%, p = 0.039) but less sensitive for peripheral airway lesions (65.1% vs. 79.1%, p = 0.046) compared with PET. SUVmax and TLG of the airway positively correlated with spirometry indicators (FEV1%pred, FEV1/FVC, MEF 50%pred, etc.) and serological inflammatory markers. Five patients died during the follow-up, with two deaths related to airway problems. Higher FDG uptake predicted worse subjective feeling, but not with symptom control or pulmonary function.
PET/CT is a valuable tool for RP with airway involvement, particularly in assessing peripheral airway lesions, and PET/CT related parameters are significantly associated with disease patterns, severity, and long-term outcomes.
RP patients with airway involvement who underwent PET/CT from January 2010 to July 2022 were retrospectively reviewed. PET/CT features were analyzed both visually and semiquantitatively with the maximum standardized uptake value (SUVmax) and total lesion glycolysis (TLG). Patterns of airway involvement on PET were summarized. Correlations of SUVmax and TLG of the airway were made with spirometric indicators and serological inflammatory markers (CRP and ESR). In addition, long-term follow-up was conducted through questionnaires in regard to symptom control, subjective feeling, pulmonary function, and quality of life.
Fifty-two cases were finally included. 18F-FDG PET showed FDG-avid lesions with increased FDG uptake in the airway among 94.2% of the patients. Three patterns (focal, multifocal and diffuse patterns) were identified. TLG of the whole airway was lower in patients with previous therapy (p = 0.046). Bronchoscopy was more sensitive in detecting tracheal abnormalities (90.7% vs.53.5%, p = 0.039) but less sensitive for peripheral airway lesions (65.1% vs. 79.1%, p = 0.046) compared with PET. SUVmax and TLG of the airway positively correlated with spirometry indicators (FEV1%pred, FEV1/FVC, MEF 50%pred, etc.) and serological inflammatory markers. Five patients died during the follow-up, with two deaths related to airway problems. Higher FDG uptake predicted worse subjective feeling, but not with symptom control or pulmonary function.
PET/CT is a valuable tool for RP with airway involvement, particularly in assessing peripheral airway lesions, and PET/CT related parameters are significantly associated with disease patterns, severity, and long-term outcomes.
摘要：
背景：18F-氟代脱氧葡萄糖（FDG）正电子发射断层扫描/计算机断层扫描（PET/CT）在评估气道受累的复发性多软骨炎（RP）中的临床价值仍存在争议。本研究旨在探讨RP伴气道受累的PET/CT特征及其在预测疾病类型、严重程度和预后。
方法：回顾性分析2010年1月至2022年7月接受PET/CT检查的气道受累RP患者。用最大标准化摄取值（SUVmax）和总病变糖酵解（TLG）对PET/CT特征进行视觉和半定量分析。总结了PET的气道受累模式。研究气道SUVmax和TLG与肺活量指标和血清炎症标志物(CRP和ESR)的相关性。此外,通过关于症状控制的问卷进行长期随访，主观感觉,肺功能,和生活质量。
结果：最终纳入52例。18F-FDGPET显示，在94.2％的患者中，气道中FDG摄取增加，富含FDG的病变。三种模式(焦点，多焦点和漫反射模式)被识别。在先前治疗的患者中，整个气道的TLG较低（p=0.046）。支气管镜检查对检测气管异常更敏感(90.7%vs.53.5%,p=0.039），但对周围气道病变的敏感性较低（65.1％vs.79.1%,p=0.046）与PET相比。气道的SUVmax和TLG与肺活量测定指标呈正相关(FEV1%pred，FEV1/FVC,MEF50%pred,等。)和血清学炎症标志物。5名患者在随访期间死亡,两例死亡与气道问题有关。较高的FDG摄取预测较差的主观感觉，但没有症状控制或肺功能。
结论：PET/CT是RP气道受累的有价值的工具，特别是在评估外周气道病变时，PET/CT相关参数与疾病模式显著相关，严重程度,和长期结果。
方法：回顾性分析2010年1月至2022年7月接受PET/CT检查的气道受累RP患者。用最大标准化摄取值（SUVmax）和总病变糖酵解（TLG）对PET/CT特征进行视觉和半定量分析。总结了PET的气道受累模式。研究气道SUVmax和TLG与肺活量指标和血清炎症标志物(CRP和ESR)的相关性。此外,通过关于症状控制的问卷进行长期随访，主观感觉,肺功能,和生活质量。
结果：最终纳入52例。18F-FDGPET显示，在94.2％的患者中，气道中FDG摄取增加，富含FDG的病变。三种模式(焦点，多焦点和漫反射模式)被识别。在先前治疗的患者中，整个气道的TLG较低（p=0.046）。支气管镜检查对检测气管异常更敏感(90.7%vs.53.5%,p=0.039），但对周围气道病变的敏感性较低（65.1％vs.79.1%,p=0.046）与PET相比。气道的SUVmax和TLG与肺活量测定指标呈正相关(FEV1%pred，FEV1/FVC,MEF50%pred,等。)和血清学炎症标志物。5名患者在随访期间死亡,两例死亡与气道问题有关。较高的FDG摄取预测较差的主观感觉，但没有症状控制或肺功能。
结论：PET/CT是RP气道受累的有价值的工具，特别是在评估外周气道病变时，PET/CT相关参数与疾病模式显著相关，严重程度,和长期结果。
