Spatial Heterogeneity of Lung Strain and Aeration and Regional Inflammation During Early Lung Injury Assessed with PET/CT

Gabriel Motta-Ribeiro; Tilo Winkler; Soshi Hashimoto; Marcos F. Vidal Melo

doi:10.1016/j.acra.2018.02.028

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Spatial Heterogeneity of Lung Strain and Aeration and Regional Inflammation During Early Lung Injury Assessed with PET/CT

Journal article

Peer reviewed

Spatial Heterogeneity of Lung Strain and Aeration and Regional Inflammation During Early Lung Injury Assessed with PET/CT

Gabriel Motta-Ribeiro, Tilo Winkler, Soshi Hashimoto and Marcos F. Vidal Melo

Academic radiology, Vol.26(3), pp.313-325

03/01/2019

DOI: 10.1016/j.acra.2018.02.028

PMCID: PMC6612262

PMID: 30057194

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Abstract

Introduction: Spatial heterogeneity of lung aeration and strain (change volume/resting volume) occurs at microscopic levels and contributes to lung injury. Yet, it is mostly assessed with histograms or large regions-of-interest. Spatial heterogeneity could also influence regional gene expression. We used positron emission tomography (PET)/computed tomography (CT) to assess the contribution of different length-scales to mechanical heterogeneity and to direct lung injury biological pathway identification. Materials and Methods: Sheep exposed to mild (n = 5, supine and n = 3, prone) and moderate (n = 6, supine) systemic endotoxemia were protectively ventilated. At baseline, 6 hours and 20 hours length-scale analysis was applied to aeration in CT (mild groups) and PET transmission (moderate group) scans; and voxel-level strain derived from image registration of end-inspiratory and end-expiratory CTs (mild). 2-deoxy-2-[(18)F]fluoro-d-glucose ( F-FDG)-PET kinetics parameters in ventral and dorsal regions were correlated with tissue microarray gene expression (moderate). Results: While aeration and strain heterogeneity were highest at 5–10 mm length-scales, larger length-scales contained a higher fraction of strain than aeration heterogeneity. Contributions of length-scales >5–10 mm to aeration and strain heterogeneity increased as lung injury progressed (p < 0.001) and were higher in supine than prone animals. Genes expressed with regional correlation to F-FDG-PET kinetics (|r| = 0.81 [0.78–0.85]) yielded pathways associated with immune system activation and fluid clearance. Conclusion: Normal spatial heterogeneity of aeration and strain suggest larger anatomical and functional determinants of lung strain than aeration heterogeneity. Lung injury and supine position increase the contribution of larger length-scales. F FDG-PET-based categorization of gene expression results in known and novel biological pathways relevant to lung injury.

Computed tomography

Gene expression

Positron emission tomography

Strain

Details

Title: Subtitle: Spatial Heterogeneity of Lung Strain and Aeration and Regional Inflammation During Early Lung Injury Assessed with PET/CT
Creators: Gabriel Motta-Ribeiro - Harvard Medical School
Tilo Winkler - Harvard University
Soshi Hashimoto - Massachusetts General Hospital
Marcos F. Vidal Melo - Harvard Medical School
Resource Type: Journal article
Publication Details: Academic radiology, Vol.26(3), pp.313-325
DOI: 10.1016/j.acra.2018.02.028
PMID: 30057194
PMCID: PMC6612262
NLM abbreviation: Acad Radiol
ISSN: 1076-6332
eISSN: 1878-4046
Number of pages: 13
Grant note: Steve Weise and Kira Grogg National Institutes of Health (http://data.elsevier.com/vocabulary/SciValFunders/100000002) HL121228 / National Institutes of Health (100000002) Department of Radiology R01HL121228 / National Heart, Lung, and Blood Institute (http://data.elsevier.com/vocabulary/SciValFunders/100000050) Massachusetts General Hospital (http://data.elsevier.com/vocabulary/SciValFunders/100005294)
Language: English
Date published: 03/01/2019
Academic Unit: Anesthesia
Record Identifier: 9985141863102771

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