呼吸肌活动在患有慢性呼吸道疾病的患者中增加。18F-FDG PET / CT可以评估呼吸肌活动。我们假设呼吸肌代谢与肺功能损伤有关，并与接受肺癌手术的患者的预后有关，因为是否呼吸肌代谢与肺功能损伤的严重程度成正比，呼吸肌高代谢是否具有预后价值？在肺癌手术前进行18F-FDG PET / CT和肺功能测试的患者被鉴定出来。在每个呼吸肌群中（斜角肌，胸锁乳突肌，肋间肌，膈肌）测量最大标准摄取值（SUVm），并归一化为肌肉肩袖舒张肌的SUVm。呼吸肌高代谢被定义为任何呼吸肌群中SUVm > 90th百分位数。从前瞻性队列中收集了临床结果。共有156名患者，男性占多数[110（71％）]，有53名（34％）有COPD之前的诊断。呼吸肌SUVm为：斜角肌：1.84 [1.51-2.25]，胸锁乳突肌1.64 [1.34-1.95]，肋间肌1.01 [0.84-1.16]，膈肌1.79 [1.41-2.27]。对于斜角肌（r = -0.29，p <0.001）和胸锁乳突肌（r = -0.17，p = 0.03）呼吸肌群，示踪剂摄取与FEV1呈负相关，与斜角肌（r = 0.17，p = 0.04）呈正相关。呼吸肌高代谢发现在45名患者中（28.8％），这些患者的最大氧摄取量较低（15.4 [14.2-17.5] vs. 17.2 mL / kg / min [15.2-21.1]，p = 0.07），并且在调整FEV1％后总体生存率较差（p <0.01）。我们的研究显示呼吸肌高代谢与肺功能损伤有关，并具有预后意义。应将18F-FDG / PET-CT作为评估呼吸肌活动和鉴定高风险患者的工具考虑进来。 ©2023作者。Respirology由约翰威立澳大利亚有限公司出版，代表亚太呼吸学会。

Respiratory muscle activity is increased in patients with chronic respiratory disease. 18 F-FDG-PET/CT can assess respiratory muscle activity. We hypothesized that respiratory muscles metabolism was correlated to lung function impairment and was associated to prognosis in patients undergoing lung cancer surgery based on the research question whether respiratory muscle metabolism quantitatively correlates with the severity of lung function impairment in patients? Does respiratory muscle hypermetabolism have prognostic value?Patients undergoing 18 F-FDG-PET/CT and pulmonary function tests prior to lung cancer surgery were identified. Maximum Standardized Uptake Value (SUVm) were measured in each respiratory muscle group (sternocleidomastoid, scalene, intercostal, diaphragm), normalized against deltoid SUVm. Respiratory muscle hypermetabolism was defined as SUVm >90th centile in any respiratory muscle group. Clinical outcomes were collected from a prospective cohort.One hundred fifty-six patients were included, mostly male [110 (71%)], 53 (34%) with previous diagnosis of COPD. Respiratory muscle SUVm were: scalene: 1.84 [1.51-2.25], sternocleidomastoid 1.64 [1.34-1.95], intercostal 1.01 [0.84-1.16], diaphragm 1.79 [1.41-2.27]. Tracer uptake was inversely correlated to FEV1 for the scalene (r = -0.29, p < 0.001) and SCM (r = -0.17, p = 0.03) respiratory muscle groups and positively correlated to TLC for the scalene (r = 0.17, p = 0.04). Respiratory muscle hypermetabolism was found in 45 patients (28.8%), who had a lower VO2 max (15.4 [14.2-17.5] vs. 17.2 mL/kg/min [15.2-21.1], p = 0.07) and poorer overall survival when adjusting to FEV1% (p < 0.01).Our findings show respiratory muscle hypermetabolism is associated with lung function impairment and has prognostic significance. 18 F-FDG/PET-CT should be considered as a tool for assessing respiratory muscle activity and to identify high-risk patients.© 2023 The Authors. Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.