Association between FDG accumulation in interstitial lesions and acute exacerbation risk in lung cancer: multicenter analysis.

IF 2.1 4区医学

Japanese Journal of Radiology Pub Date : 2025-09-12 DOI:10.1007/s11604-025-01869-4

Yuriko Ishida, Shiro Watanabe, Jun Sakakibara-Konishi, Yasuyuki Ikezawa, Hajime Kikuchi, Yasutaka Kawai, Hirokazu Kimura, Sho Nakakubo, Kenji Hirata, Kohsuke Kudo, Satoshi Konno

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引用次数: 0

Abstract

Purpose: Interstitial pneumonia (IP) is associated with poor prognosis in lung cancer and increases the risk of acute exacerbation (AE). Few studies analyzed the relationship between fluorodeoxyglucose (FDG) accumulation in IP with lung cancer complicated with IP and the incidence of AE. This study investigates the association between FDG accumulation in the interstitial lesions and the AE incidence in patients with lung cancer complicated with IP.

Materials and methods: This multicenter, retrospective study included patients with lung cancer complicated with IP who received chemotherapy. All CTs at baseline and the onset of AE were centrally adjudicated. The SUVpeak and FDGscore for interstitial lesions were calculated from FDG positron emission tomography images before chemotherapy, and these values were corrected using reference uptake. To determine the association with AE risk, clinical characteristics and imaging findings were compared between patients who developed AE and those who did not. Subsequently, logistic regression analysis was performed to identify risk factors for the development of AE.

Results: One hundred and thirteen patients who met the eligibility criteria were enrolled from three centers. However, 9 patients with a clinical diagnosis of collagen-related interstitial pneumonia were excluded due to predominant FDG accumulation in the interstitial lesions, and 104 patients were analyzed. Of those patients, 31.7% (33/104) developed all grade AE and 18.3% (19/104) developed grade 3 or higher. There were no significant differences in patient characteristics and imaging patterns between those with and without AE. SUVpeak in the ipsilateral and contralateral interstitial lesions to the tumor and the FDGscore did not differ between those with or without AE.

Conclusions: No association was observed between FDG accumulation in interstitial lesions and AE in patients with lung cancer complicated with IP. We may have to remain cautious about the risk of AE in lung cancer complicated with IP, even when FDG accumulation in interstitial lesions is high or low.

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肺癌间质性病变中FDG积累与急性加重风险的关系：多中心分析

目的：间质性肺炎（IP）与肺癌预后不良相关，并增加急性加重（AE）的风险。很少有研究分析肺癌合并IP患者中氟脱氧葡萄糖（FDG）积累与AE发生率的关系。本研究探讨肺癌合并IP患者间质病变中FDG的积累与AE发生率的关系。材料与方法：本研究为多中心回顾性研究，纳入了接受化疗的肺癌合并IP患者。所有基线和AE发病的ct集中判定。根据化疗前FDG正电子发射断层扫描图像计算间质病变的SUVpeak和FDGscore，并使用参考摄取对这些值进行校正。为了确定与AE风险的关系，比较了发生AE和未发生AE的患者的临床特征和影像学表现。随后，进行逻辑回归分析，以确定AE发展的危险因素。结果：从三个中心入组了113例符合入选标准的患者。然而，9例临床诊断为胶原相关性间质性肺炎的患者因间质病变主要为FDG积聚而被排除，共分析了104例患者。在这些患者中，31.7%（33/104）发展为所有级别AE， 18.3%（19/104）发展为3级或更高级别AE。有和没有AE的患者的特征和影像学模式没有显著差异。同侧和对侧肿瘤间质病变的SUVpeak和FDGscore在有无AE的患者之间没有差异。结论：肺癌合并IP患者间质病变中FDG积累与AE无相关性。即使间质性病变中FDG蓄积量是高还是低，我们可能必须对肺癌并发IP发生AE的风险保持谨慎。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Japanese Journal of Radiology Medicine-Radiology, Nuclear Medicine and Imaging

自引率

4.80%

发文量

133

期刊介绍： Japanese Journal of Radiology is a peer-reviewed journal, officially published by the Japan Radiological Society. The main purpose of the journal is to provide a forum for the publication of papers documenting recent advances and new developments in the field of radiology in medicine and biology. The scope of Japanese Journal of Radiology encompasses but is not restricted to diagnostic radiology, interventional radiology, radiation oncology, nuclear medicine, radiation physics, and radiation biology. Additionally, the journal covers technical and industrial innovations. The journal welcomes original articles, technical notes, review articles, pictorial essays and letters to the editor. The journal also provides announcements from the boards and the committees of the society. Membership in the Japan Radiological Society is not a prerequisite for submission. Contributions are welcomed from all parts of the world.