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In vivo evaluation of TNF-alpha in the lungs of patients affected by sarcoidosis.

Galli F, Lanzolla T, Pietrangeli V, Malviya G, Ricci A, Bruno P, Ragni P, Scopinaro F, Mariotta S, Signore A - Biomed Res Int (2015)

Bottom Line: SUV mean and SUV max were calculated over lungs for FDG.Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

View Article: PubMed Central - PubMed

Affiliation: Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, "Sapienza" University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy.

ABSTRACT

Introduction: Sarcoidosis is a multisystemic granulomatous disorder characterized by multiple noncaseating granulomas involving intrathoracic lymph nodes and lung parenchyma. Recently, the use of anti-tumor necrosis factor alpha (anti-TNFα) agents has been introduced for therapy of chronic and refractory sarcoidosis with controversial results. Infliximab (Remicade) is a chimeric monoclonal antibody (mAb) that recognizes and binds TNFα, neutralizing its biological effects. In the present study,   (99m)Tc labelled infliximab was used to study the expression of TNFα in sarcoid lesions and to evaluate its role as a predictive marker in response to therapy with Remicade.

Material and methods: A total of 10 patients with newly diagnosed sarcoidosis were enrolled together with 10 control patients affected by rheumatoid arthritis. All patients were studied by planar imaging of the chest with   (99m)Tc-infliximab at 6 h and 24 h and total body [(18)F]-FDG PET/CT. Regions of interest were drawn over the lungs and the right arm and target-to-background ratios were analysed for   (99m)Tc-infliximab. SUV mean and SUV max were calculated over lungs for FDG.

Results and discussion: Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.

Conclusion: In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

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Related in: MedlinePlus

99mTc-Infliximab scintigraphy of a sarcoidosis patient (patient 4/F) acquired at 6 h (anterior and posterior views (a)) and at 24 h (anterior and posterior views (b)) showing a moderate and diffuse uptake in the lung parenchima. [18F]-FDG PET/CT images of the same patient showing a focal/hyleal uptake (coronal and transaxial sections (c)).
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fig2: 99mTc-Infliximab scintigraphy of a sarcoidosis patient (patient 4/F) acquired at 6 h (anterior and posterior views (a)) and at 24 h (anterior and posterior views (b)) showing a moderate and diffuse uptake in the lung parenchima. [18F]-FDG PET/CT images of the same patient showing a focal/hyleal uptake (coronal and transaxial sections (c)).

Mentions: The qualitative analysis of scintigraphy with 99mTc-infliximab showed no pathological focal accumulation of the labeled antibody (Table 1). Both images at 6 h, characterized by high vascular activity, and images at 24 h did not show the same pathological uptakes highlighted in the preliminary PET study (Figures 1 and 2). The pulmonary distribution of the two radiopharmaceuticals was different, being predominantly diffused in the case of 99mTc-infliximab and rather focal with ileal involvement in the PET scans.


In vivo evaluation of TNF-alpha in the lungs of patients affected by sarcoidosis.

Galli F, Lanzolla T, Pietrangeli V, Malviya G, Ricci A, Bruno P, Ragni P, Scopinaro F, Mariotta S, Signore A - Biomed Res Int (2015)

99mTc-Infliximab scintigraphy of a sarcoidosis patient (patient 4/F) acquired at 6 h (anterior and posterior views (a)) and at 24 h (anterior and posterior views (b)) showing a moderate and diffuse uptake in the lung parenchima. [18F]-FDG PET/CT images of the same patient showing a focal/hyleal uptake (coronal and transaxial sections (c)).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4383433&req=5

fig2: 99mTc-Infliximab scintigraphy of a sarcoidosis patient (patient 4/F) acquired at 6 h (anterior and posterior views (a)) and at 24 h (anterior and posterior views (b)) showing a moderate and diffuse uptake in the lung parenchima. [18F]-FDG PET/CT images of the same patient showing a focal/hyleal uptake (coronal and transaxial sections (c)).
Mentions: The qualitative analysis of scintigraphy with 99mTc-infliximab showed no pathological focal accumulation of the labeled antibody (Table 1). Both images at 6 h, characterized by high vascular activity, and images at 24 h did not show the same pathological uptakes highlighted in the preliminary PET study (Figures 1 and 2). The pulmonary distribution of the two radiopharmaceuticals was different, being predominantly diffused in the case of 99mTc-infliximab and rather focal with ileal involvement in the PET scans.

Bottom Line: SUV mean and SUV max were calculated over lungs for FDG.Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

View Article: PubMed Central - PubMed

Affiliation: Nuclear Medicine Unit, Department of Medical-Surgical Sciences and Translational Medicine, Faculty of Medicine and Psychology, Ospedale S. Andrea, "Sapienza" University of Rome, Via di Grottarossa 1035, 00189 Roma, Italy.

ABSTRACT

Introduction: Sarcoidosis is a multisystemic granulomatous disorder characterized by multiple noncaseating granulomas involving intrathoracic lymph nodes and lung parenchyma. Recently, the use of anti-tumor necrosis factor alpha (anti-TNFα) agents has been introduced for therapy of chronic and refractory sarcoidosis with controversial results. Infliximab (Remicade) is a chimeric monoclonal antibody (mAb) that recognizes and binds TNFα, neutralizing its biological effects. In the present study,   (99m)Tc labelled infliximab was used to study the expression of TNFα in sarcoid lesions and to evaluate its role as a predictive marker in response to therapy with Remicade.

Material and methods: A total of 10 patients with newly diagnosed sarcoidosis were enrolled together with 10 control patients affected by rheumatoid arthritis. All patients were studied by planar imaging of the chest with   (99m)Tc-infliximab at 6 h and 24 h and total body [(18)F]-FDG PET/CT. Regions of interest were drawn over the lungs and the right arm and target-to-background ratios were analysed for   (99m)Tc-infliximab. SUV mean and SUV max were calculated over lungs for FDG.

Results and discussion: Image analysis showed low correlation between T/B ratios and BAL results in patients despite positivity at [(18)F]-FDG PET.

Conclusion: In conclusion, patients with newly diagnosed pulmonary sarcoidosis, with FDG-PET and BAL positivity, showed a negative   (99m)Tc-infliximab scintigraphy.

Show MeSH
Related in: MedlinePlus