Acute exacerbation of interstitial lung disease with lung cancer after surgery: evaluation with 2-[18]-fluoro-2-deoxy-D-glucose positron emission tomography.

ABSTRACT

PURPOSE: Interstitial lung disease (ILD) has been associated with primary lung cancer and an increased risk of postoperative acute exacerbation (AE). The effectiveness of 2-[18]-fluoro-2-deoxy-D-glucose ((18)F-FDG) positron emission tomography (PET) for staging lung cancer is well established. This study investigates the association of FDG uptake on PET in patients with AE of ILD. METHODS: The subjects of this retrospective study were 1309 patients with lung cancer, who underwent pulmonary resection at Shizuoka Cancer Center between September, 2002 and January, 2011. ILD was diagnosed with chest computed tomography in 95 patients, 81 of whom underwent (18)F-FDG PET before surgery. Six patients suffered from AE after surgery (AE group), while the remaining 75 (non-AE group) did not. We investigated the clinico-pathological findings and the results of FDG uptake on PET using the value of the I/M ratio, which is the ratio of the peak of standardized uptake value (SUV) of the ILD area to the mean SUV of the mediastinum. RESULTS: There was no significant difference in clinico-pathological findings, but a significance difference in the I/M ratio (P = 0.0102). CONCLUSION: The FDG uptake in PET may be a predictive factor for AE of ILD in patients who have undergone lung cancer surgery.