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Initial [18F]FDG PET/CT study for survival evaluation of lung transplantation patients with interstitial lung disease
Lin Chen1,2,3, Jing Wang1,2,3, Chentao Jin1,2,3
1Department of Nuclear Medicine and Medical PET Center, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou, Zhejiang, China.
Purpose:
This study aimed to investigate the role of [18F]fluorodeoxyglucose ([18F]FDG) positron emission tomography/computed tomography (PET/CT) in survival prediction of interstitial lung diseases (ILD) patients undergoing lung transplantation (LTx).
Methods:
Eighty-three patients with ILD who underwent LTx were retrospectively included in this study, among whom 43 received unilateral LTx and 40 received bilateral LTx. All the patients received [18F]FDG PET/CT scanning prior to LTx. Clinical characteristics and [18F]FDG PET/CT parameters were analyzed by using univariate and multivariate analysis to identify predictive factors for overall survival (OS). Correlation of post-operative extracorporeal membrane oxygenation (ECMO) time with clinical and [18F]FDG PET/CT parameters was analyzed by using Pearson's correlation analysis.
Results:
Post-operative ECMO time (p < 0.001), age (p = 0.006) and LDH (p = 0.015) were independent predictive factors for OS of unilateral LTx patients. In addition, LDH (p = 0.03) and gender (p = 0.03) were identified as independent factors for OS of bilateral LTx patients. Especially, we found that glucose metabolism (maximum standardized uptake values (SUVmax) of non-transplanted lung, SUVmaxNT) was an independent factor for OS (p = 0.027) of unilateral LTx patients. For patients with bilateral LTx, SUVmin of bilateral lungs exhibited a strong trend in predicting OS (p = 0.08). Furthermore, SUVmean, SUVsum and total lesion glycolysis (TLG) were significantly correlated with post-operative ECMO time.
Conclusion:
This study for the first time suggested that [18F]FDG PET/CT could be a potential approach in predicting OS of LTx patients with ILD, which might be helpful for the survival evaluation of ILD patients with LTx.
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