Ortiz SG1*, Alfonso BR1 and de Ureta PT2
1Nuclear Medicine Service, Puerta de Hierro Majadahonda University Hospital, Spain
2Internal Medicine Service, Puerta de Hierro Majadahonda University Hospital, Spain
Pulmonary involvement is a common manifestation of Dermatomyositis (DM), the most frequent histologic pattern being Interstitial Lung Disease (ILD) which is a major contributor to morbidity and mortality in these patients. Therefore, this disease should be investigated and it is essential to perform Pulmonary Function Tests (PFTs) and High-Resolution Computed Tomography (HRCT) early in the course of the disease to make a definitive diagnosis. Nowadays, 2-deoxy-2-[18F]Fluoro- D-Glucose Positron Emission Tomography/Computed Tomography (2-[18F]FDG PET/CT) can be a useful tool for patients diagnosed with DM since, in addition to observing the state of inflammatory myopathy and detecting possible associated malignant tumors, it allows early identification of ILD, before structural changes occur. We present the case of a 45-year-old patient with a diagnosis of DM, who requested 2-[18F]FDG PET/CT to rule out possible occult neoplasia, showing pathological uptake of moderate intensity and peripheral predominance in the posterior segments of both lower lobes that coincides with a very discrete increase in pulmonary interstitial density, which translates as an active inflammatory pathology, to rule out ILD. Given the findings on 2-[18F]FDG PET/CT, it was decided to perform a HRCT showing pulmonary interstitial involvement with reticular pattern and ground glass, predominantly peripheral and basal, suggest ILD. PFTs showed a progressive drop in KCO (71%), so, in view of these findings, ILD was diagnosed and immunosuppressive treatment was prescribed. A control CT was performed showing improvement of the interstitial involvement. Currently the patient is clinically asymptomatic, without PFR alteration (KCO 75%) and ILD radiology stability. In conclusion 2-[18F]FDG PET/CT can help in the early diagnosis, clinical course and treatment of ILD in patients with DM.
Ortiz SG, Alfonso BR, de Ureta PT. Early Detection of Interstitial Lung Disease in Asymptomatic Patients with 2-[18F]FDG PET/CT. Ann Clin Case Rep. 2022; 7: 2302..