The lungs were on fire: a pilot study of <sup>18</sup>F-FDG PET/CT in idiopathic-inflammatory-myopathy-related interstitial lung disease

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Abstract

Background

Interstitial lung disease (ILD) and its rapid progression (RP) are the main contributors to unfavourable outcomes of patients with idiopathic inflammatory myopathy (IIM). This study aimed to identify the clinical value of PET/CT scans in IIM-ILD patients and to construct a predictive model for RP-ILD.

Methods

Adult IIM-ILD patients who were hospitalized at four divisions of the First Affiliated Hospital, Zhejiang University School of Medicine (FAHZJU), from 1 January 2017 to 31 December 2020 were reviewed. PET/CT scans and other characteristics of patients who met the inclusion and exclusion criteria were collected and analysed.

Results

A total of 61 IIM-ILD patients were enrolled in this study. Twenty-one patients (34.4%) developed RP-ILD, and 24 patients (39.3%) died during follow-up. After false discovery rate (FDR) correction, the percent-predicted diffusing capacity of the lung for carbon monoxide (DLCO%, P = 0.014), bilateral lung mean standard uptake value (SUVmean, P = 0.014) and abnormal mediastinal lymph node ( P = 0.045) were significantly different between the RP-ILD and non-RP-ILD groups. The subsequent univariate and multivariate logistic regression analyses verified our findings. A “DLM” model was established by including the above three values to predict RP-ILD with a cut-off value of ≥ 2 and an area under the curve (AUC) of 0.905. Higher bilateral lung SUVmean ( P = 0.019) and spleen SUVmean ( P = 0.011) were observed in IIM-ILD patients who died within 3 months, and a moderate correlation was recognized between the two values.

Conclusions

Elevated bilateral lung SUVmean, abnormal mediastinal lymph nodes and decreased DLCO% were significantly associated with RP-ILD in IIM-ILD patients. The “DLM” model was valuable in predicting RP-ILD and requires further validation.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13075-021-02578-9.

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Author and article information

Contributors

Jin Lin: linjinzju@zju.edu.cn

Journal

Journal ID (nlm-ta): Arthritis Res Ther

Journal ID (iso-abbrev): Arthritis Res Ther

Title: Arthritis Research & Therapy

Publisher: BioMed Central (London )

ISSN (Print): 1478-6354

ISSN (Electronic): 1478-6362

Publication date (Electronic): 23 July 2021

Publication date PMC-release: 23 July 2021

Publication date (Print): 2021

Volume: 23

Electronic Location Identifier: 198

Affiliations

[1 ]GRID grid.452661.2, ISNI 0000 0004 1803 6319, Department of Rheumatology, , The First Affiliated Hospital, Zhejiang University School of Medicine, ; #79 Qingchun Road, Hangzhou, 310003 Zhejiang Province People’s Republic of China

[2 ]GRID grid.452661.2, ISNI 0000 0004 1803 6319, PET Center, , The First Affiliated Hospital, Zhejiang University School of Medicine, ; #79 Qingchun Road, Hangzhou, 310003 Zhejiang Province People’s Republic of China

[3 ]GRID grid.452661.2, ISNI 0000 0004 1803 6319, Department of Respiratory Diseases, , The First Affiliated Hospital, Zhejiang University School of Medicine, ; #79 Qingchun Road, Hangzhou, 310003 Zhejiang Province People’s Republic of China

Article

Publisher ID: 2578

DOI: 10.1186/s13075-021-02578-9

PMC ID: 8298695

PubMed ID: 34301306

SO-VID: 439c3c50-6dd8-4e04-98b3-60d00cd46639

License:

Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

History

Date received : 22 April 2021

Date accepted : 9 July 2021

Funding

Funded by: FundRef http://dx.doi.org/10.13039/501100001809, National Natural Science Foundation of China;

Award ID: 81701602

Award Recipient : Heng Cao

Custom metadata

ScienceOpen disciplines: Orthopedics

Keywords: idiopathic inflammatory myopathy,interstitial lung disease,pet/ct scan,dermatomyositis,polymyositis

Data availability:

ScienceOpen disciplines: Orthopedics

Keywords: idiopathic inflammatory myopathy, interstitial lung disease, pet/ct scan, dermatomyositis, polymyositis