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European Journal of Nuclear Medicine and Molecular Imaging

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01-02-2005 | Original Article

Involvement of pulmonary endothelial cell injury in the pathogenesis of pulmonary fibrosis: clinical assessment by¹²³I-MIBG lung scintigraphy

Authors: Noriaki Takabatake, Tsuyoshi Arao, Makoto Sata, Shuichi Abe, Sumito Inoue, Yoko Shibata, Yasuchika Takeishi, Isao Kubota

Published in: European Journal of Nuclear Medicine and Molecular Imaging | Issue 2/2005

Abstract

Purpose

Pulmonary microvascular endothelial injury may be involved in the pathogenesis of pulmonary fibrosis (PF). The aim of this study was to evaluate the pulmonary vascular status in patients with PF by lung scintigraphic assessment of ¹²³I-metaiodobenzylguanidine (¹²³I-MIBG), which reflects latent endothelial cell lesions.

Methods

We assessed lung ¹²³I-MIBG kinetics and clinical indices in 23 PF patients and 16 controls. Mean uptake ratios of lung to mediastinum (L/M) were calculated in anterior planar images at 30 (early image) and 270 (delayed image) min after intravenous injection of ¹²³I-MIBG. The pulmonary mean washout rate (WR) of ¹²³I-MIBG was also calculated.

Results

The L/M ratio in early images, but not in delayed images, was significantly lower in the PF patients than in the controls (L/M_early 1.41±0.14 vs 1.53±0.10, p<0.01; L/M_delayed 1.28±0.10 vs 1.33±0.07, p=NS). WR was significantly reduced in the PF patients compared with the controls (28.6%±3.1% vs 34.2%±5.1%, p<0.001). In the study subjects (PF patients plus controls) there were significant relationships between lung WR of ¹²³I-MIBG and other diagnostic parameters for the severity of PF, such as vital capacity (r=0.625, p<0.0001), total lung capacity (r=0.691, p<0.0001), carbon monoxide diffusing capacity (r=0.622, p<0.0001), serum angiotensin-converting enzyme activity (r=0.422, p<0.01), carbohydrate antigen KL-6 levels (r=−0.495, p<0.01) and surfactant protein-D levels (r=−0.461, p<0.01). When control subjects were excluded, similar significant correlations were observed between WR and %TLC (r=0.508, p<0.05), DL_CO (r=0.593, p<0.01) and serum ACE activity (r=0.515, p<0.05) in the PF patients.

Conclusion

These results suggest that endothelial cell injury plays a significant role in the pathogenesis of PF, and that lung WR of ¹²³I-MIBG, which is a specific marker of endothelial damage, can serve as a novel diagnostic tool to evaluate the functional severity of PF.

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Title: Involvement of pulmonary endothelial cell injury in the pathogenesis of pulmonary fibrosis: clinical assessment by 123I-MIBG lung scintigraphy
Authors: Noriaki Takabatake
Tsuyoshi Arao
Makoto Sata
Shuichi Abe
Sumito Inoue
Yoko Shibata
Yasuchika Takeishi
Isao Kubota
Publication date: 01-02-2005
Publisher: Springer-Verlag
Published in: European Journal of Nuclear Medicine and Molecular Imaging / Issue 2/2005
Print ISSN: 1619-7070
Electronic ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1663-1

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Springer Medicine

Involvement of pulmonary endothelial cell injury in the pathogenesis of pulmonary fibrosis: clinical assessment by¹²³I-MIBG lung scintigraphy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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