Evolving Role of PET/CT-MRI in Assessing Muscle Disorders

Kothekar, Esha; Raynor, William; Al-Zaghal, Abdullah; Jonnakuti, Venkata S.; Werner, Thomas; Alavi, Abass

doi:10.1016/j.cpet.2018.08.010

Cited by 8 publications

(2 citation statements)

References 67 publications

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“…Overall, our observations lend support to the idea that 18 F‐FDG‐PET/CT may be worth investigating as a means to evaluate respiratory muscle activity globally and quantitatively. As a technique already in use for assessing skeletal muscles in other applications, 40,41 18 F‐FDG‐PET/CT could give access to new information, currently inaccessible in the clinical setting, namely a description of the recruitment of the various respiratory muscle groups and of the relative intensities of their recruitment. This could be of particular interest to assess the efficacy of therapeutic interventions aiming at reducing respiratory muscle activity, including noninvasive ventilatory support, an often‐difficult clinical challenge.…”

Section: Discussionmentioning

confidence: 99%

Respiratory muscle metabolic activity on PET/CT correlates with obstructive ventilatory defect severity and prognosis in patients undergoing lung cancer surgery

et al. 2023

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Background and Objective Respiratory muscle activity is increased in patients with chronic respiratory disease. 18F‐FDG‐PET/CT can assess respiratory muscle activity. We hypothesized that respiratory muscles metabolism was correlated to lung function impairment and was associated to prognosis in patients undergoing lung cancer surgery based on the research question whether respiratory muscle metabolism quantitatively correlates with the severity of lung function impairment in patients? Does respiratory muscle hypermetabolism have prognostic value? Methods Patients undergoing 18F‐FDG‐PET/CT and pulmonary function tests prior to lung cancer surgery were identified. Maximum Standardized Uptake Value (SUVm) were measured in each respiratory muscle group (sternocleidomastoid, scalene, intercostal, diaphragm), normalized against deltoid SUVm. Respiratory muscle hypermetabolism was defined as SUVm >90th centile in any respiratory muscle group. Clinical outcomes were collected from a prospective cohort. Results One hundred fifty‐six patients were included, mostly male [110 (71%)], 53 (34%) with previous diagnosis of COPD. Respiratory muscle SUVm were: scalene: 1.84 [1.51–2.25], sternocleidomastoid 1.64 [1.34–1.95], intercostal 1.01 [0.84–1.16], diaphragm 1.79 [1.41–2.27]. Tracer uptake was inversely correlated to FEV1 for the scalene (r = −0.29, p < 0.001) and SCM (r = −0.17, p = 0.03) respiratory muscle groups and positively correlated to TLC for the scalene (r = 0.17, p = 0.04). Respiratory muscle hypermetabolism was found in 45 patients (28.8%), who had a lower VO2 max (15.4 [14.2–17.5] vs. 17.2 mL/kg/min [15.2–21.1], p = 0.07) and poorer overall survival when adjusting to FEV1% (p < 0.01). Conclusion Our findings show respiratory muscle hypermetabolism is associated with lung function impairment and has prognostic significance. 18F‐FDG/PET‐CT should be considered as a tool for assessing respiratory muscle activity and to identify high‐risk patients.

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Section: Discussionmentioning

confidence: 99%

Respiratory muscle metabolic activity on PET/CT correlates with obstructive ventilatory defect severity and prognosis in patients undergoing lung cancer surgery

et al. 2023

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“…Similar to skeletal muscle glucose uptake, 18 Ffluorodeoxyglucose (FDG) enters the cells via the GLUTs. FDG-PET/CT has assumed an important role in muscle disorder evaluation [14][15][16], and shown superiority over CT alone and MRI in assessing some muscle disorders [14].…”

Section: Introductionmentioning

confidence: 99%

18F-FDG-PET/CT in measuring volume and global metabolic activity of thigh muscles: a novel CT-based tissue segmentation methodology

Kothekar

Yellanki

Borja

et al. 2020

Nuclear Medicine Communications

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We present a novel computed tomography CT-based tissue segmentation methodology for determining volume and global uptake of FDG of the thigh muscles and correlate these parameters with age. Materials and Methods A total of 71 subjects from a prospective clinical trial [NCT01724749] were included. PET/CT scans were acquired 180 min after intravenous injection of FDG. A 3D growing region algorithm with neighborhood Hounsfield unit (HU) threshold between 1 and 150 was used to highlight the muscle. FDG uptake was expressed as the average mean standardized uptake value (SUVmean) normalized for lean body mass (average SULmean). Femur volume was used to normalize thigh muscle volume to calculate normalized volume and correlate with age. Results We found a significant negative correlation between normalized volume and age (left side r=-0.262, p=0.02; right side r=-0.286, p=0.01). No statistically significant difference was found between SUL and age (left side r=0.10, p=0.41; right side r=0.14, p=0.24) or between SUL and BMI (left side r=0.03, p=0.78; right side r=0.02, p=0.90). There was no statistically significant difference in muscle volume on the two sides (left 3606.5±1195.6 cm 3 , right 3633.5±1215.7 cm 3 , p=0.28). Statistically significant difference was noted in the global metabolic activity (SUL) between the two sides (left 0.39±0.06, right 0.42±0.08, p<0.001), with 56/71 (78.8%) subjects having higher uptake on the right side. Conclusion FDG-PET/CT using CT-based segmentation is a novel imaging modality assessing the volume and global metabolic activity of the thigh muscles. It could be possible to utilize this methodology for the research and understanding of lower limb muscle pathophysiology.

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