What is the role of nuclear imaging in the workup of idiopathic pulmonary fibrosis (IPF)?

Updated: Aug 06, 2018
  • Author: Ali Nawaz Khan, MBBS, FRCS, FRCP, FRCR; Chief Editor: Eugene C Lin, MD  more...
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Answer

Answer

In cases of IPF, perfusion lung scintigraphy shows nonspecific, subsegmental mismatched perfusion defects. These are not correlated with clinical severity.

Gallium-67 imaging has not proven to be of value in cases of established IPF. [26]

Technetium-99m diethylenetriamine penta-acetic acid (DTPA) is cleared more rapidly when capillary permeability is increased than when it is not, and the findings may provide an index of lung inflammation. [27] Fluorodeoxyglucose (FDG) positron-emission tomography (PET) may show FDG accumulation in the lung bases; such findings correlate with the honeycomb fibrosis seen on high-resolution HRCT. [28, 29, 30, 31, 32]

Win et al studied 13 patients with IPF recruited for 2 thoracic 18F FDG-PET studies performed within 2 weeks of each other. All patients were diagnosed with IPF in consensus at multidisciplinary meetings because of typical clinical, HRCT, and pulmonary function test features. The purpose of the study twas o investigate the reproducibility of pulmonary 18F FDG-PET in patients with IPF. This study demonstrated that there is excellent short-term reproducibility in pulmonary 18F FDG uptake in patients with IPF. [33]


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