Novel non-invasive assessment of upper airway inflammation in obstructive sleep apnea using positron emission tomography/magnetic resonance imaging.
Novel non-invasive assessment of upper airway inflammation in obstructive sleep apnea using positron emission tomography/magnetic resonance imaging.
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DOI：
10.1007/s11325-021-02480-3
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发表时间：
2022-09
期刊：
影响因子：
--
通讯作者：
Shah NA
中科院分区：
文献类型：
--
作者：
Cohen O;John MM;Kaufman AE;Kundel V;Burschtin O;Khan S;Fayad Z;Mani V;Shah NA
开发一种新的无创技术，使用正电子发射断层扫描/磁共振成像（PET/MRI）量化阻塞性睡眠呼吸暂停（OSA）患者的上气道炎症。初治中重度OSA患者接受[18 F]-氟-2-脱氧-D-葡萄糖（FDG）PET/MRI。三名阅片员独立进行了MRI咽部软组织描记。标准化摄取值（SUV）是从相应的PET图像上的感兴趣区域（ROI）描记生成的。从胸锁乳突肌测量背景SUV。使用组内相关系数（ICC）分析比较了阅片者之间的SUV和目标背景（TBR）。使用Bland-Altman图和Pearson相关系数，在每位阅片人之间比较单个图像切片的SUV。由一名阅片人重复所有描记，以评估阅片人内可靠性。五名参与者完成了我们的成像方案和分析。中位年龄、体重指数和呼吸暂停低通气指数分别为41岁（IQR 40.5-68.5）、32.7 kg/m2（IQR 28.1-38.1）和30.7起事件/小时（IQR 19.5-48.1）。最高代谢活性区域始终定位于腭或舌扁桃体邻近粘膜。25例ICC符合极佳一致性标准。其余三个是TBR测量，符合良好一致性的标准。头对头比较显示每个读者之间的强相关性。我们的新成像技术证实了上呼吸道FDG亲合力的可靠定量。这项技术对未来探索OSA患者和暴露于污染物的局部气道炎症的工作具有重要意义。它还可以作为评估工具，用于评估对OSA治疗的反应。
To develop a novel non-invasive technique to quantify upper airway inflammation using positron emission tomography/magnetic resonance imaging (PET/MRI) in patients with obstructive sleep apnea (OSA). Patients with treatment naïve moderate-to-severe OSA underwent [18F]-Fluoro-2-deoxy-D-glucose (FDG) PET/MRI. Three readers independently performed tracings of the pharyngeal soft tissue on MRI. Standardized uptake values (SUV) were generated from region of interest (ROI) tracings on corresponding PET images. Background SUV was measured from the sternocleidomastoid muscle. SUV and target-to-background (TBR) were compared across readers using intraclass correlation coefficient (ICC) analyses. SUV from individual image slices were compared between each reader using Bland-Altman plots and Pearson correlation coefficients. All tracings were repeated by one reader for assessment of intra-reader reliability. Five participants completed our imaging protocol and analysis. Median age, body mass index, and apnea-hypopnea index were 41 years (IQR 40.5-68.5), 32.7 kg/m2 (IQR 28.1-38.1), and 30.7 event per hour (IQR 19.5-48.1), respectively. The highest metabolic activity regions were consistently localized to palatine or lingual tonsil adjacent mucosa. Twenty-five ICC met criteria for excellent agreement. The remaining three were TBR measurements which met criteria for good agreement. Head-to-head comparisons revealed strong correlation between each reader. Our novel imaging technique demonstrated reliable quantification of upper airway FDG avidity. This technology has implications for future work exploring local airway inflammation in individuals with OSA and exposure to pollutants. It can also serve as an assessment tool for response to OSA therapies.
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