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.

中文翻译：

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18F-FDG PET / CT对肺癌和化学疗法治疗的间质性肺病患者间质性肺病急性加重的预测价值。

背景我们研究了在化疗之前进行氟18 2-氟-2-脱氧-D-葡萄糖正电子发射断层扫描/计算机断层扫描（18F-FDG PET / CT）是否可以预测间质性肺疾病（AE-ILD）的急性发作）肺癌和ILD患者接受化疗。方法回顾性分析2006年4月至2018年3月间在熊本大学医院接受18F-FDG PET / CT化疗的33例肺癌和ILD患者。测量间质病变的最大标准化摄取值（SUVmax）以量化背景ILD活性。使用SUVmax的逻辑回归分析开发了AE-ILD的预测模型，并进行了接收器工作特性（ROC）曲线分析。结果33例患者中，7位经验丰富的AE-ILD。有或无AE-ILD的患者对侧间质病变的SUVmax明显更高（中位SUVmax：2.220 vs. 1.795，P = 0.025）。Logistic回归分析表明，对侧间质病变的SUVmax趋向于与AE-ILD的发作显着相关[几率：8.683，95％置信区间（CI）为0.88-85.83，P = 0.064]。用于预测AE-ILD的SUVmax的ROC曲线下面积为0.780（95％CI 0.579-0.982，P = 0.025）。SUVmax的最佳临界值为2.005，敏感性和特异性分别为0.857和0.769。结论18F-FDG PET / CT图像中对侧间质病变的SUVmax可能有助于预测肺癌和化疗后ILD患者的AE-ILD发作。