Image-derived input function for assessment of 18F-FDG uptake by the inflamed lung

Tobias Schroeder, Marcos F. Vidal Melo, Guido Musch, R. Scott Harris, Jose G. Venegas, Tilo Winkler

Research output: Contribution to journalArticlepeer-review

34 Scopus citations

Abstract

Pulmonary uptake of 18F-FDG assessed with PET has been used to quantify the metabolic activity of inflammatory cells in the lung. This assessment involves modeling of tracer kinetics and knowledge of a time-activity curve in pulmonary artery plasma as an input function, usually acquired by manual blood sampling. This paper presents and validates a method to accurately derive an input function from a blood-pool region of interest (ROI) defined in dynamic PET images. Methods: The method is based on a 2-parameter model describing the activity of blood and that from spillover into the time-activity curve for the ROI. The model parameters are determined using an iterative algorithm, with 2 blood samples used to calibrate the raw PET-derived activity data. We validated both the 2-parameter model and the method to derive a quantitative input function from ROIs defined for the cavities of the right and left heart and for the descending aorta by comparing them against the time-activity curve obtained by manual blood sampling from the pulmonary artery in lungs with acute inflammation. Results: The model accurately described the time-activity curve from sampled blood. The 2-sample calibration method provided an efficient algorithm to derive input functions that were virtually identical to those sampled manually, including the fast kinetics of the early phase. The 18F-FDG uptake rates in acutely injured lungs obtained using this method correlated well with those obtained exclusively using manual blood sampling (R2 > 0.993). Within some bounds, the model was found quite insensitive to the timing of calibration blood samples or the exact definition of the blood-pool ROIs. Conclusion: Using 2 mixed venous blood samples, the method accurately assesses the entire time course of the pulmonary 18F-FDG input function and does not require the precise geometry of a specific blood-pool ROI or a population-based input function. This method may substantially facilitate studies involving modeling of pulmonary 18F-FDG in patients with viral or bacterial infections, pulmonary fibrosis, and chronic obstructive pulmonary disease.

Original languageEnglish
Pages (from-to)1889-1896
Number of pages8
JournalJournal of Nuclear Medicine
Volume48
Issue number11
DOIs
StatePublished - Nov 1 2007
Externally publishedYes

Keywords

  • Acute lung injury
  • F-FDG
  • Inflammation
  • Massachusetts General Hospital
  • PET

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