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
Open accessAbstract
Background We examined whether fluorine-18 2-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography (18 F-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 18 F-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 (SUV max) 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 SUV max, and receiver operating characteristic (ROC) curve analyses were conducted. Results Among the 33 patients, 7 experienced AE-ILD. The SUV max of contralateral interstitial lesions was significantly higher in patients with vs. without AE-ILD (median SUV max: 2.220 vs. 1.795, P = 0.025). Univariable logistic regression analyses showed that the SUV max 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 SUV max for predicting AE-ILD was 0.780 (95% CI 0.579-0.982, P = 0.025). The optimal cut-off value for SUV max was 2.005, with sensitivity and specificity values of 0.857 and 0.769, respectively. Conclusions The SUV max of contralateral interstitial lesions in 18 F-FDG PET/CT images might be useful for predicting the onset of AE-ILD in patients with lung cancer and ILD treated with chemotherapy.
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Drug-induced lung injury occurs more frequently in groups with high CRP, SUVmax, or GPS.
“Furthermore, drug‑induced lung injury occurs more frequently in groups with high CRP, SUVmax, or GPS(32‑34).”
From Clinical impact of inflammatory and nutrition index based on metabolic tumor activity in non‑small cell lung cancer treated with immunotherapy. (2024) · cites this paper as [33]
The Abstract reports higher SUVmax in patients who experienced chemotherapy-related acute exacerbation of ILD than in those who did not (2.220 vs. 1.795; P = 0.025). This supports the SUVmax portion for patients with lung cancer and pre-existing ILD, but not the broader claim about drug-induced lung injury; this source does not establish the CRP or GPS portions of the multiply cited sentence. (LLM, conf=0.84)
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Self-citation
- Authors
- Akaike, K., Saruwatari, K., Oda, S., Shiraishi, S., Takahashi, H., Hamada, S., Iyama, S., Horio, Y., Tomita, Y., Saeki, S., Okamoto, S., Ichiyasu, H., Fujii, K., & Sakagami, T.
- Affiliations
- Kumamoto University Hospital (JP)
- Kumamoto University (JP)
- Corresponding author
- Saruwatari, Koichi
- ORCID
- Venue
- International Journal of Clinical Oncology
- Published
- 2019-11-28
- Volume
- 25
- Issue
- 4
- Pages
- 681-690
- ISSN
- 1341-9625 (ISSN-L)
- 1437-7772
- OpenAlex
- W2991077970
- Cited by
- 23
- References
- 18
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 5 · 2023: 2 · 2022: 3 · 2021: 10 · 2020: 1
- FWCI
- 2.78
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- International Journal of Clinical Oncology (publishedVersion)
- PubMed (publishedVersion)
- Kumamoto University Repository (Kumamoto University) (submittedVersion, cc-by-nc-nd)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Interstitial Lung Diseases and Idiopathic Pulmonary Fibrosis
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Lung Cancer Diagnosis and Treatment
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Radiomics and Machine Learning in Medical Imaging
- Keywords
- acute exacerbation of interstitial lung disease, interstitial lung disease, lung cancer, chemotherapy-induced lung injury, 18F-FDG PET/CT, standardized uptake value, predictive biomarkers
- MeSH terms
- Positron Emission Tomography Computed Tomography, Aged, Female, Humans, Lung Neoplasms, Male, Middle Aged, Retrospective Studies, ROC Curve, Sensitivity and Specificity, Lung Diseases, Interstitial, Fluorodeoxyglucose F18
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