Positron emission tomography is a three-dimensional imaging technique that measures physiological effects, including metabolism. 18 Fluorodeoxyglucose has been extensively used as a tracer of cellular energy metabolism in the brain and in tumour detection. As neutrophils utilise glucose as an energy source during their respiratory burst, it was hypothesised that 18 fluorodeoxyglucose uptake, by these cells, could be interpreted as a measure of neutrophil activation in cystic fibrosis (CF).Ten adult CF patients were given a bolus intravenous injection of 18 fluorodeoxyglucose, followed by a 90-min dynamic mid-lung acquisition scan. Right-lung 18 fluorodeoxyglucose uptake was assessed using a Patlak plot and values were converted to glucose utilisation. Three clinically inactive pulmonary sarcoidosis patients served as controls.From the 10 CF patients with baseline sputum neutrophils of 14610 6 cells?mL -1 who were investigated, seven were found to have sputum at a normal or slightly depressed glucose utilisation rate (mean 1.33 mmol?g Positron emission tomography (PET) is a powerful, quantitative, nuclear medicine tomographic imaging technique. PET can be used to measure physiological effects such as blood flow, metabolism, ventilation, receptor occupancy, regional dose delivery and pharmacokinetics of radiolabelled drugs [1]. It combines principles of image reconstruction from projections with the use of specific biological molecules labelled with positron-emitting radioisotopes ( 11 C, 18 F, 15 O, 13 N) allowing regional measurements of dynamic processes to be taken. 18 FDG differs from glucose by the substitution of the hydroxyl group with a fluorine atom on the second carbon of the glucose. When injected intravenously, 18 FDG rapidly diffuses into the extracellular spaces throughout the body. It is transported into living cells by the same mechanism as glucose, via the D-glucose transporter and is phosphorylated by hexokinase to fluoro-deoxyglucose-6-phosphate. The deoxy substitution at the second carbon position prevents further metabolism and the product accumulates in the cell at a rate that reflects glucose metabolism. Increased glucose consumption is assumed to lead to an increased rate of tracer uptake. The rate of accumulation of 18 FDG in tissue after intravenous injection reflects the combined transport and hexokinase activity in the cells [9].18 FDG-PET studies of the lung are still relatively few compared with the number of oncological, neurological and cardiac studies.The inflammatory process, in particular neutrophils, has been implicated in the pathogenesis of a variety of lung diseases including cystic fibrosis (CF), bronchiectasis, and chronic bronchitis. Neutrophils contribute to pulmonary destruction by production and release of cytotoxic enzymes (e.g. elastase, myeloperoxidase) and toxic oxygen metabolites [10]. Markers of inflammation in blood, bronchoalveolar lavage (BAL), sputum and lung biopsy serve as indirect measurements of inflammation, making the detection of re...