The investigation of right ventricular function in patients with lung transplant patients using FDG-PET and MIBG scintigraphy

• Project/Area Number: 18K07653
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 52040:Radiological sciences-related
• Research Institution: Fukuoka University
• Principal Investigator: Nagamachi Shigeki 福岡大学, 医学部, 教授 (40180517)
• Co-Investigator(Kenkyū-buntansha): 白石 武史 福岡大学, 医学部, 教授 (10216179) ; 野々熊 真也 福岡大学, 医学部, 助教 (20773229) ; 平塚 昌文 佐賀大学, 医学部, 講師 (90369017)
• Project Period (FY): 2018-04-01 – 2024-03-31
• Project Status: Completed (Fiscal Year 2023)
• Budget Amount: ¥4,420,000 (Direct Cost: ¥3,400,000、Indirect Cost: ¥1,020,000); Fiscal Year 2020: ¥1,300,000 (Direct Cost: ¥1,000,000、Indirect Cost: ¥300,000); Fiscal Year 2019: ¥1,690,000 (Direct Cost: ¥1,300,000、Indirect Cost: ¥390,000); Fiscal Year 2018: ¥1,430,000 (Direct Cost: ¥1,100,000、Indirect Cost: ¥330,000)
• Keywords: 肺移植 / FDG-PET / 右心機能 / 肺血流シンチ / 肺換気シンチ / MIBGシンチ / 心臓交感神経障害 / 肺線維症 / 慢性呼吸不全 / UCG / 心臓交感神経機能 / SUVmax / 右心室不全 / 非移植肺容積 / MIBG / 肺解剖容積 / 肺機能容積 / 右心不全 / FDG-PET/CT / 心筋MIBG シンチ

Outline of Final Research Achievements

Lung transplantation is a curative treatment for refractory chronic respiratory failure caused by idiopathic interstitial pneumonia or severe obstructive disease. In the present study, we evaluated the alteration of right ventricular function by monitoring FDG uptake of right ventricular myocardium before and after lung transplantation. The uptake of FDG-PET in the right ventricle was likely to be associated with the degree of active pulmonary fibrous lesions in conjunction with right ventricular dysfunction. These phenomenon disappeared or improved after the pulmonary transplantation, in conjunction with the improvement of right ventricular function, such as RVSP or TPRG. In conclusion, FDG-PET was useful in monitoring the right ventricular overload in the chronic respiratory failure, which relieved by pulmonary transplantation.

Academic Significance and Societal Importance of the Research Achievements

肺移植予定患者は難治性の慢性呼吸不全状態にあるが、経過中に肺高血圧に基づく右心不全を来す場合がある。移植術前後、遠隔期における右心代謝異常を含む右心機能、心肺の脱交感神経状態を評価することで、肺移植の適応決定、心不全に対し介入する支持療法の選択をする上で重要な指標になる可能性がある。また片側移植患者における有効な分肺機能指標を確立するため肺血流シンチと肺換気シンチを用い移植肺と非移植肺のカウント比を求めた。またHigh resolution CT から肺解剖容積を求め、移植肺/残存肺の容積比として測定した。分肺機能を考慮したこれらも重要な指標になる可能性がある。

Research Products

• [Presentation] The usefulness of evaluating FDG uptake in right ventricle and in pulmonary fibrotic lesions for monitoring right ventricular function before and after pulmonary transplantation in patients with chronic respiratory failure. (2022)
  • Author(s): Shigeki Nagamachi. MD, Takeshi Shiraishi *. MD, Ryuichi Waseda *. MD, Sou Miyahara *.MD, Toshihiko Sato *.MD, Kengo Yoshimitsu. MD
  • Organizer: 2022.米国核医学会
  • Int'l Joint Research
• [Presentation] 片側肺移植後の肺機能容積と解剖容積の変化ー基礎疾患に基づく比較ー (2022)
  • Author(s): 長町茂樹、吉満研吾、白石武史＊、早稲田龍一＊ 、宮原聡
  • Organizer: 2022日本核医学会総会
• [Presentation] The alteration of FDG uptake in the right ventricular myocardium before and after lung transplantation in patients with chronic respiratory failure. (2021)
  • Author(s): Shigeki Nagamachi, Masanari Nonokuma, Yasuo Kuwabara, Takeshi Shiraishi,Kengo Yoshimitsu
  • Organizer: 米国核医学会
  • Int'l Joint Research
• [Presentation] Serial change of functional volume of non-transplanted lung before and after unilateral lung transplantation (2021)
  • Author(s): Shigeki Nagamachi, Takeshi Shiraishi, Ryuichi Waseda, Kengo Yoshimitsu
  • Organizer: 欧州核医学会
  • Int'l Joint Research
• [Presentation] The alteration of FDG uptake in the right ventricular myocardium before and after lung transplantation in patients with chronic respiratory failure. (2021)
  • Author(s): Shigeki Nagamachi
  • Organizer: 米国核医学会
  • Int'l Joint Research
• [Presentation] Serial change of respiratory function of non-transplanted lung after unilateral lung transplantation-Comparison of CT volumetric (2020)
  • Author(s): Shigeki Nagamachi
  • Organizer: 米国核医学会
  • Int'l Joint Research
• [Presentation] 片肺移植前後の肺機能容積と解剖学的容積の変化の比較 (2020)
  • Author(s): 長町茂樹
  • Organizer: 第60回日本核医学学術総会
• [Presentation] Serial change of respiratory function of non-transplanted lung after unilateral lung transplantation-Comparison of CT volumetric- (2020)
  • Author(s): Shigeki Nagamachi
  • Organizer: 米国核医学会
  • Int'l Joint Research