Combined PET and X-ray Computed Tomography Imaging in Pulmonary Infections and Inflammation

Jamshed Bomanji; Ahmad Almuhaideb; Alimuddin Zumla


Curr Opin Pulm Med. 2011;17(3):197-205. 

In This Article

Therapeutic Response Monitoring

In the current climate of cost constraints, the ability to monitor effective response at an early stage is a major advantage. Ozsahin et al.[41] demonstrated that following effective therapy for invasive aspergillosis, 18F-FDG PET findings reverted to normal. Animal experiments have also shown that 18F-FDG PET is accurate for monitoring responses following antibiotic therapy in the setting of soft tissue infection.[42] In a clinical study, 18F-FDG uptake returned to normal levels after successful antifungal therapy for a lung abscess caused by candidal infection[43] and after therapy for Pneumocystis carinii pneumonia.[44]

Few noninvasive biomarkers for pulmonary inflammation are currently available that can assess the lung-specific response to anti-inflammatory treatments. Chen et al.[45] evaluated the ability of 18F-FDG PET to measure the pulmonary anti-inflammatory effects of hydroxymethylglutaryl-co-enzyme A reductase inhibitors (statins) and recombinant human-activated protein C (rhAPC) in a human model of experimentally induced lung inflammation in 18 healthy volunteers. They showed that 18F-FDG PET imaging is a sensitive method for quantifying the lung-specific response to anti-inflammatory therapies and may serve as an attractive platform for assessing the efficacy of novel anti-inflammatory therapies at early phases in the drug development process (Fig. 5).

Figure 5.

Therapy response assessment in patient with histology-proven sarcoidosis
Baseline lower panel and follow-up upper panel 18F-FDG PET/CT scans (from left to right: MIP, axial PET, axial CT and axial fused PET/CT) after 6 months of treatment show interval reduction of FDG activity at the mediastinal (orange arrow) and bilateral hilar (yellow arrow) lymphadenopathy indicating good response to therapy. FDG, fluorodeoxyglucose; MIP, maximum intensity projection.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.