P42 Increased FDG uptake in areas of ‘normal’ lung in idiopathic pulmonary fibrosis
Bibliographic record
Abstract
<h3>Background</h3> Idiopathic pulmonary fibrosis (IPF) has a variable disease course and we lack biomarkers that accurately predict prognosis or treatment response. Positron Emission Tomography-Computed Tomography (PET-CT) provides structural and functional information about the lung. A study of 25 IPF patients reported increased 18[F]-FDG uptake in areas of normal lung compared to controls.<sup>1</sup> If confirmed, this raises the possibility that PET-CT can identify ‘microscopic fibrosis’ with prognostic implications. We assess 18[F]-FDG uptake in areas of lung with normal CT appearance in a second IPF cohort. <h3>Methods</h3> PET-CT scans undertaken for cancer staging at an interstitial lung disease tertiary referral centre were reviewed. IPF patients and controls without lung disease were identified. 18[F]-FDG uptake was assessed using manual region of interest (ROI) placement in areas of lung with normal CT appearance in IPF patients and controls. ROI were placed away from the mediastinum and concomitant tumours. 18[F]-FDG uptake within ROI was expressed as maximum and mean standardised uptake values (SUV) normalised using body weight. Mean Hounsfield Units (HU) were evaluated to assess for subtle differences in radiodensity within ROI. Data are presented as mean ± SD. Unpaired, 2-tailed T-tests were used to compare between group differences with a P value < 0.05 considered significant. <h3>Results</h3> Forty-five subjects were included in this study (15 IPF and 30 controls). Lung cancer was the most common concomitant malignancy in both groups. There was no difference in mean HU within ROI between IPF and controls (−719 ± 79 HU in IPF and −723 ± 147 HU in controls. P = 0.92). Areas of normal lung in IPF patients exhibited increased 18[F]-FDG uptake compared to controls measured by maximum SUV (0.98 ± 0.32 in IPF and 0.70 ± 0.20 in controls, P <0.01) and mean SUV (0.80 ± 0.29 in IPF and 0.57 ± 0.18 in controls, P < 0.01). <h3>Conclusions</h3> We confirm that in IPF, areas of normal appearing lung exhibit increased 18[F]-FDG uptake compared with corresponding areas in controls. A longitudinal study is required to establish the relationship between 18[F]-FDG uptake, disease progression and treatment response. <h3>Reference</h3> Win T, Thomas BA, Lambrou T, <i>et al</i>. Areas of normal pulmonary parenchyma on HRCT exhibit increased FDG PET signal in IPF patients. <i>Eur J Nucl Med Mol Imaging</i> 2013;<b>41</b>(2):337–42.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".