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FDG-PET in patients at risk for acute respiratory distress syndrome: a preliminary report

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Abstract

Objective

To compare the pattern of lung uptake of 18F-fluorodeoxyglucose (FDG) by positron emission tomography (PET) imaging in patients with lung contusion that developed or did not progress to acute respiratory distress syndrome (ARDS).

Design

Prospective, observational study.

Setting

Trauma Center (academic urban hospital).

Patients and interventions

Eight patients with blunt thoracic trauma and pulmonary contusion, confirmed by computed tomography (CT) on admission, underwent repeat CT and FDG-PET (on the same day) 24–72 h after admission.

Results

No subjects met the criteria for ARDS at the time of the PET and second CT. Four subjects subsequently developed ARDS 1–3 days after the PET scan; the other four did not develop the syndrome. Three of the four subjects who subsequently developed ARDS showed diffuse FDG uptake throughout the entire lungs, while those who did not develop ARDS showed significant FDG uptake only in areas of focal lung opacity (non or poorly aerated lung units) on CT. FDG uptake in normally aerated lung regions was higher for those who subsequently developed ARDS than those who did not, approaching statistical significance. The normally aerated tissue:liver ratio was significantly higher in subjects who developed ARDS than in those who did not (P = 0.029).

Conclusion

In this small series of patients with thoracic trauma, diffuse lung uptake of FDG was detected by PET imaging 1–3 days prior to clinically determined ARDS.

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References

  1. Chen DL, Schuster DP (2006) Imaging pulmonary inflammation with positron emission tomography: a biomarker for drug development. Mol Pharm 3:488–495

    Article  CAS  PubMed  Google Scholar 

  2. Chen DL, Rosenbluth DB, Mintun MA, Schuster DP (2006) FDG-PET imaging of pulmonary inflammation in healthy volunteers after airway instillation of endotoxin. J Appl Physiol 100:1602–1609

    Article  CAS  PubMed  Google Scholar 

  3. Schuster DP (2007) The opportunities and challenges of developing imaging biomarkers to study lung function and disease. Am J Respir Crit Care Med 176:224–230

    Article  PubMed  Google Scholar 

  4. Richard JC, Le Bars D, Costes N, Bregeon F, Tourvieille C, Lavenne F, Janier M, Gimenez G, Guerin C (2006) Alveolar recruitment assessed by positron emission tomography during experimental acute lung injury. Intensive Care Med 32:1889–1894

    Article  PubMed  Google Scholar 

  5. Matthay MA, Zimmerman GA (2005) Acute lung injury and the acute respiratory distress syndrome: four decades of inquiry into pathogenesis and rational management. Am J Respir Cell Mol Biol 33:319–327

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Matthay MA, Zimmerman GA, Esmon C, Bhattacharya J, Coller B, Doerschuk CM, Floros J, Gimbrone MA Jr, Hoffman E, Hubmayr RD, Leppert M, Matalon S, Munford R, Parsons P, Slutsky AS, Tracey KJ, Ward P, Gail DB, Harabin AL (2003) Future research directions in acute lung injury: summary of a National heart, lung, and blood Institute working group. Am J Respir Crit Care Med 167:1027–1035

    Article  PubMed  Google Scholar 

  7. Zimmerman GAAK, McIntyre TM (2003) Pathogenesis of sepsis and septic-induced lung injury. In: Matthay MA (ed) Acute respiratory distress syndrome, lung biology in health and disease, vol 179. Marcel Dekker Inc, New York, pp 245–287

    Google Scholar 

  8. Gattinoni L, Caironi P, Pelosi P, Goodman LR (2001) What has computed tomography taught us about the acute respiratory distress syndrome? Am J Respir Crit Care Med 164:1701–1711

    Article  CAS  PubMed  Google Scholar 

  9. Miller PR, Croce MA, Bee TK, Qaisi WG, Smith CP, Collins GL, Fabian TC (2001) ARDS after pulmonary contusion: accurate measurement of contusion volume identifies high-risk patients. J Trauma 51:223–228 (discussion 229–230)

    Article  CAS  PubMed  Google Scholar 

  10. Westerterp M, Pruim J, Oyen W, Hoekstra O, Paans A, Visser E, van Lanschot J, Sloof G, Boellaard R (2007) Quantification of FDG PET studies using standardised uptake values in multi-centre trials: effects of image reconstruction, resolution and ROI definition parameters. Eur J Nucl Med Mol Imaging 34:392–404

    Article  PubMed  Google Scholar 

  11. Paquet N, Albert A, Foidart J, Hustinx R (2004) Within-patient variability of (18)F-FDG: standardized uptake values in normal tissues. J Nucl Med 45:784–788

    CAS  PubMed  Google Scholar 

  12. Bernard GR, Artigas A, Brigham KL, Carlet J, Falke K, Hudson L, Lamy M, Legall JR, Morris A, Spragg R (1994) The American–European Consensus Conference on ARDS. Definitions, mechanisms, relevant outcomes, and clinical trial coordination. Am J Respir Crit Care Med 149:818–824

    Article  CAS  PubMed  Google Scholar 

  13. Dowdy DW, Eid MP, Dennison CR, Mendez-Tellez PA, Herridge MS, Guallar E, Pronovost PJ, Needham DM (2006) Quality of life after acute respiratory distress syndrome: a meta-analysis. Intensive Care Med 32:1115–1124

    Article  PubMed  Google Scholar 

  14. Maggiore SM, Antonelli M (2006) Expanding our horizons beyond the intensive care unit: does mechanism of lung injury influence the quality of life in ARDS survivors? Intensive Care Med 32:1683–1685

    Article  PubMed  Google Scholar 

  15. Chen DL, Schuster DP (2004) Positron emission tomography with [18F]fluorodeoxyglucose to evaluate neutrophil kinetics during acute lung injury. Am J Physiol Lung Cell Mol Physiol 286:L834–L840

    Article  CAS  PubMed  Google Scholar 

  16. Paik JY, Lee KH, Choe YS, Choi Y, Kim BT (2004) Augmented 18F-FDG uptake in activated monocytes occurs during the priming process and involves tyrosine kinases and protein kinase C. J Nucl Med 45:124–128

    CAS  PubMed  Google Scholar 

  17. Musch G, Venegas JG, Bellani G, Winkler T, Schroeder T, Petersen B, Harris RS, Melo MF (2007) Regional gas exchange and cellular metabolic activity in ventilator-induced lung injury. Anesthesiology 106:723–735

    Article  CAS  PubMed  Google Scholar 

  18. Schuster DP, Stark T, Stephenson J, Royal H (2002) Detecting lung injury in patients with pulmonary edema. Intensive Care Med 28:1246–1253

    Article  PubMed  Google Scholar 

  19. Jacene HA, Cohade C, Wahl RL (2004) F–18 FDG PET/CT in acute respiratory distress syndrome: a case report. Clin Nucl Med 29:786–788

    Article  PubMed  Google Scholar 

  20. Schroeder T, Vidal Melo MF, Musch G, Harris RS, Venegas JG, Winkler T (2008) Modeling Pulmonary Kinetics of 2-Deoxy–2-[(18)F]fluoro-d-glucose During Acute Lung Injury. Acad Radiol 15:763–775

    Article  PubMed  PubMed Central  Google Scholar 

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Acknowledgments

R.S.R. was supported by a Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES) fellowship and F.A.B by a Conselho Nacional de Pesquisa (CNPq) fellowship.

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Authors and Affiliations

  1. Department of Radiology, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil

    R. S. Rodrigues & E. Marchiori

  2. Department of Surgery, Wake Forest University, Winston-Salem, NC, USA

    P. R. Miller

  3. IPEC, Fundação Oswaldo Cruz, Rio de Janeiro, Rio de Janeiro, Brazil

    F. A. Bozza

  4. Department of Radiology, Federal University of Fluminense, Rio de Janeiro, Brazil

    E. Marchiori

  5. Department of Internal Medicine and Program in Human Molecular Biology and Genetics, University of Utah, Salt Lake City, UT, USA

    G. A. Zimmerman

  6. Huntsman Cancer Institute, University of Utah, Salt Lake City, UT, USA

    J. M. Hoffman

  7. Department of Radiology, University of Utah, Salt Lake City, UT, USA

    K. A. Morton

  8. University of Utah Hospitals and Clinics, 30 North 1900 East. Room 1A71, Salt Lake City, UT, 84132-2140, USA

    K. A. Morton

Authors
  1. R. S. Rodrigues
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  2. P. R. Miller
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  3. F. A. Bozza
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  4. E. Marchiori
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  5. G. A. Zimmerman
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  6. J. M. Hoffman
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  7. K. A. Morton
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Corresponding author

Correspondence to K. A. Morton.

Electronic supplementary material

Arterial blood gas data. (DOC 32 kb)

This material is unfortunately not available in the Publisher's archive anymore: Contusion volume (PPS 1640 kb)

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Rodrigues, R.S., Miller, P.R., Bozza, F.A. et al. FDG-PET in patients at risk for acute respiratory distress syndrome: a preliminary report. Intensive Care Med 34, 2273–2278 (2008). https://doi.org/10.1007/s00134-008-1220-7

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  • DOI: https://doi.org/10.1007/s00134-008-1220-7

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