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Predictive value of 18F-FDG PET/CT for acute exacerbation of interstitial lung disease in patients with lung cancer and interstitial lung disease treated with chemotherapy

  • Kimitaka Akaike
  • Koichi SaruwatariEmail author
  • Seitaro Oda
  • Shinya Shiraishi
  • Hiroshi Takahashi
  • Shohei Hamada
  • Shinji Iyama
  • Yuko Horio
  • Yusuke Tomita
  • Sho Saeki
  • Shinichiro Okamoto
  • Hidenori Ichiyasu
  • Kazuhiko Fujii
  • Takuro Sakagami
Original Article

Abstract

Background

We examined whether fluorine-18 2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) performed before chemotherapy could predict the onset of acute exacerbation of interstitial lung disease (AE-ILD) in patients with lung cancer and ILD treated with chemotherapy.

Methods

Thirty-three patients with lung cancer and ILD who underwent 18F-FDG PET/CT and were treated with chemotherapy at Kumamoto University Hospital between April 2006 and March 2018 were retrospectively analyzed. The maximum standardized uptake value (SUVmax) of interstitial lesions was measured to quantify the background ILD activity. A prediction model of AE-ILD was developed using logistic regression analyses for the SUVmax, and receiver operating characteristic (ROC) curve analyses were conducted.

Results

Among the 33 patients, 7 experienced AE-ILD. The SUVmax of contralateral interstitial lesions was significantly higher in patients with vs. without AE-ILD (median SUVmax: 2.220 vs. 1.795, P = 0.025). Univariable logistic regression analyses showed that the SUVmax of contralateral interstitial lesions trended towards being significantly associated with the onset of AE-ILD [odds ratio: 8.683, 95% confidence interval (CI) 0.88–85.83, P = 0.064]. The area under the ROC curve of the SUVmax for predicting AE-ILD was 0.780 (95% CI 0.579–0.982, P = 0.025). The optimal cut-off value for SUVmax was 2.005, with sensitivity and specificity values of 0.857 and 0.769, respectively.

Conclusions

The SUVmax of contralateral interstitial lesions in 18F-FDG PET/CT images might be useful for predicting the onset of AE-ILD in patients with lung cancer and ILD treated with chemotherapy.

Keywords

Acute exacerbation Fluorine-18 2-fluoro-2-deoxy-d-glucose positron emission tomography/computed tomography Interstitial lung disease Lung cancer Chemotherapy 

Notes

Acknowledgements

We are grateful to Ms. Tamura and Ms. Tashiro, who are secretaries at department of respiratory medicine at Kumamoto University Hospital, for their support. The authors declare that they have no support by NIH Grants.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Supplementary material

10147_2019_1584_MOESM1_ESM.doc (64 kb)
Supplementary file1 (DOC 64 kb)
10147_2019_1584_MOESM2_ESM.doc (72 kb)
Supplementary file2 (DOC 72 kb)
10147_2019_1584_MOESM3_ESM.doc (62 kb)
Supplementary file3 (DOC 62 kb)
10147_2019_1584_MOESM4_ESM.pdf (100 kb)
Supplementary Figure 1. Association between AE and the SUVmean of contralateral (a), ipsilateral (b), and regardless of ipsilateral or contralateral (c) interstitial lesions. footnote: AE, acute exacerbation; SUV, standard uptake value; ILD, interstitial lung disease (PDF 100 kb)
10147_2019_1584_MOESM5_ESM.pdf (167 kb)
Supplementary Figure 2. Representative case of AE-ILD. CT scan; (a)(b), 18F-FDG PET before chemotherapy; (c)(d), respectively. The SUVmax of contralateral interstitial lesion (solid line) was 3.14. CT scan at the onset of AE-ILD; (e)(f) (PDF 166 kb)

References

  1. 1.
    Ozawa Y, Suda T, Naito T et al (2009) Cumulative incidence of and predictive factors for lung cancer in IPF. Respirology (Carlton, Vic) 14(5):723–728.  https://doi.org/10.1111/j.1440-1843.2009.01547.x CrossRefGoogle Scholar
  2. 2.
    Tomassetti S, Gurioli C, Ryu JH et al (2015) The impact of lung cancer on survival of idiopathic pulmonary fibrosis. Chest 147(1):157–164.  https://doi.org/10.1378/chest.14-0359 CrossRefPubMedGoogle Scholar
  3. 3.
    Minegishi Y, Takenaka K, Mizutani H et al (2009) Exacerbation of idiopathic interstitial pneumonias associated with lung cancer therapy. Intern Med (Tokyo, Japan) 48(9):665–672CrossRefGoogle Scholar
  4. 4.
    Shukuya T, Ishiwata T, Hara M et al (2010) Carboplatin plus weekly paclitaxel treatment in non-small cell lung cancer patients with interstitial lung disease. Anticancer Res 30(10):4357–4361PubMedGoogle Scholar
  5. 5.
    Kenmotsu H, Naito T, Kimura M et al (2011) The risk of cytotoxic chemotherapy-related exacerbation of interstitial lung disease with lung cancer. J Thorac Oncol 6(7):1242–1246.  https://doi.org/10.1097/JTO.0b013e318216ee6b CrossRefPubMedGoogle Scholar
  6. 6.
    Kakiuchi S, Hanibuchi M, Tezuka T et al (2017) Analysis of acute exacerbation of interstitial lung disease associated with chemotherapy in patients with lung cancer: a feasibility of S-1. Respir Investig 55(2):145–152.  https://doi.org/10.1016/j.resinv.2016.10.008 CrossRefPubMedGoogle Scholar
  7. 7.
    Enomoto Y, Inui N, Kato T et al (2016) Low forced vital capacity predicts cytotoxic chemotherapy-associated acute exacerbation of interstitial lung disease in patients with lung cancer. Lung Cancer (Amsterdam, Netherlands) 96:63–67.  https://doi.org/10.1016/j.lungcan.2016.03.017 CrossRefGoogle Scholar
  8. 8.
    Chao F, Zhang H (2012) PET/CT in the staging of the non-small-cell lung cancer. J Biomed Biotechnol 2012:783739.  https://doi.org/10.1155/2012/783739 CrossRefPubMedPubMedCentralGoogle Scholar
  9. 9.
    Justet A, Laurent-Bellue A, Thabut G et al (2017) [(18)F]FDG PET/CT predicts progression-free survival in patients with idiopathic pulmonary fibrosis. Respir Res 18(1):74.  https://doi.org/10.1186/s12931-017-0556-3 CrossRefPubMedPubMedCentralGoogle Scholar
  10. 10.
    Raghu G, Remy-Jardin M, Myers JL et al (2018) Diagnosis of idiopathic pulmonary fibrosis. An official ATS/ERS/JRS/ALAT clinical practice guideline. Am J Respir Crit Care Med 198(5):e44–e68.  https://doi.org/10.1164/rccm.201807-1255ST CrossRefPubMedGoogle Scholar
  11. 11.
    Raghu G, Collard HR, Egan JJ et al (2011) An official ATS/ERS/JRS/ALAT statement: idiopathic pulmonary fibrosis: evidence-based guidelines for diagnosis and management. Am J Respir Crit Care Med 183(6):788–824.  https://doi.org/10.1164/rccm.2009-040GL CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Groves AM, Win T, Screaton NJ et al (2009) Idiopathic pulmonary fibrosis and diffuse parenchymal lung disease: implications from initial experience with 18F-FDG PET/CT. J Nucl Med 50(4):538–545.  https://doi.org/10.2967/jnumed.108.057901 CrossRefPubMedGoogle Scholar
  13. 13.
    Brown RS, Leung JY, Kison PV et al (1999) Glucose transporters and FDG uptake in untreated primary human non-small cell lung cancer. J Nucl Med 40(4):556–565PubMedGoogle Scholar
  14. 14.
    van Baardwijk A, Dooms C, van Suylen RJ et al (2007) The maximum uptake of (18)F-deoxyglucose on positron emission tomography scan correlates with survival, hypoxia inducible factor-1alpha and GLUT-1 in non-small cell lung cancer. Eur J Cancer (Oxford, England 1990) 43(9):1392–1398.  https://doi.org/10.1016/j.ejca.2007.03.027 CrossRefGoogle Scholar
  15. 15.
    El-Chemaly S, Malide D, Yao J et al (2013) Glucose transporter-1 distribution in fibrotic lung disease: association with [(1)(8)F]-2-fluoro-2-deoxyglucose-PET scan uptake, inflammation, and neovascularization. Chest 143(6):1685–1691.  https://doi.org/10.1378/chest.12-1359 CrossRefPubMedGoogle Scholar
  16. 16.
    Andrianifahanana M, Hernandez DM, Yin X et al (2016) Profibrotic up-regulation of glucose transporter 1 by TGF-beta involves activation of MEK and mammalian target of rapamycin complex 2 pathways. FASEB J 30(11):3733–3744.  https://doi.org/10.1096/fj.201600428R CrossRefPubMedPubMedCentralGoogle Scholar
  17. 17.
    Bergeron A, Soler P, Kambouchner M et al (2003) Cytokine profiles in idiopathic pulmonary fibrosis suggest an important role for TGF-beta and IL-10. Eur Respir J 22(1):69–76CrossRefGoogle Scholar
  18. 18.
    Lodge MA (2017) Repeatability of SUV in Oncologic (18)F-FDG PET. J Nucl Med 58(4):523–532.  https://doi.org/10.2967/jnumed.116.186353 CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Kimitaka Akaike
    • 1
  • Koichi Saruwatari
    • 1
    Email author
  • Seitaro Oda
    • 2
  • Shinya Shiraishi
    • 2
  • Hiroshi Takahashi
    • 1
  • Shohei Hamada
    • 1
  • Shinji Iyama
    • 1
  • Yuko Horio
    • 1
  • Yusuke Tomita
    • 1
  • Sho Saeki
    • 1
  • Shinichiro Okamoto
    • 1
  • Hidenori Ichiyasu
    • 1
  • Kazuhiko Fujii
    • 1
  • Takuro Sakagami
    • 1
  1. 1.Department of Respiratory Medicine, Kumamoto University Hospital, Faculty of Life SciencesKumamoto UniversityKumamotoJapan
  2. 2.Department of Diagnostic Radiology, Faculty of Life SciencesKumamoto UniversityKumamotoJapan

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