{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T05:17:08Z","timestamp":1788239828966,"version":"build-2803163510"},"reference-count":22,"publisher":"MDPI AG","issue":"17","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Center for Science in Poland","award":["2017\/25\/N\/NZ5\/02689"],"award-info":[{"award-number":["2017\/25\/N\/NZ5\/02689"]}]},{"name":"Medical University of Bialystok"},{"id":[{"id":"https:\/\/ror.org\/00y4ya841","id-type":"ROR","asserted-by":"publisher"}]},{"name":"leading national research center in Bialystok"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background: Pulmonary arterial hypertension (PAH) is characterized by progressive vascular remodeling and right ventricular (RV) dysfunction. 18F-FDG PET\/MRI may reveal metabolic alterations in the pulmonary parenchyma and vasculature. We investigated pulmonary FDG uptake in PAH versus healthy controls and its associations with hemodynamics, RV function, and clinical outcomes. Methods: Twenty-eight stable PAH patients and 12 age-matched healthy controls underwent 18F-FDG PET\/MRI. Standardized uptake values (SUVs) were measured in lung parenchyma and proximal pulmonary arteries. Hemodynamic parameters were obtained via right heart catheterization; RV\u2013PA coupling was assessed as stroke volume\/end-systolic volume (SV\/ESV). Twenty PAH patients underwent follow-up imaging after targeted therapy. Clinical endpoints (CEPs: death, hospitalization, disease progression) were analyzed by Kaplan\u2013Meier and Cox regression. Results: PAH patients showed markedly elevated lung parenchymal SUV (0.405 [0.338\u20130.533] vs. 0.225 [0.207\u20130.273], p &lt; 0.001) and proximal PA SUV (3.46 [1.95\u20136.89] vs. 1.48 [1.15\u20131.65], p &lt; 0.001). The two metrics were uncorrelated (r = +0.105, p = 0.595). SUV PA Proximal correlated with mPAP (r = +0.551) and PVR (r = +0.517), while SUV Lung showed no hemodynamic correlations. After 24 months of therapy, RV\u2013PA coupling improved significantly (p = 0.037); lung SUV showed a non-significant trend toward reduction (\u0394 = \u22120.10, p = 0.128). Sixteen CEPs occurred; impaired RV\u2013PA coupling (HR = 0.04, p = 0.002), elevated mPAP (HR = 1.08, p &lt; 0.001), and reduced RVEF (HR = 0.91, p &lt; 0.001) were strong univariable predictors. Neither SUV metric retained independent prognostic value in multivariable analysis. Conclusions: Pulmonary parenchymal and proximal PA FDG uptake are markedly elevated in PAH. However, neither metric independently predicts hemodynamic severity or clinical outcomes, limiting their current role as reliable prognostic surrogates.<\/jats:p>","DOI":"10.3390\/jcm15176672","type":"journal-article","created":{"date-parts":[[2026,8,31]],"date-time":"2026-08-31T09:21:19Z","timestamp":1788168079000},"page":"6672","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pulmonary Parenchymal 18F-FDG Uptake on PET\/MRI in Pulmonary Arterial Hypertension: A Comparative Study with Healthy Controls and Prognostic Implications"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4517-1498","authenticated-orcid":false,"given":"Remigiusz","family":"Kazimierczyk","sequence":"first","affiliation":[{"name":"Department of Cardiology, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"},{"role":"project-administration","vocabulary":"credit"},{"role":"funding-acquisition","vocabulary":"credit"},{"role":"investigation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8178-6583","authenticated-orcid":false,"given":"Piotr M.","family":"Szumowski","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Stephan G.","family":"Nekolla","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Technical University Munich, Ismaninger Str., 81675 Munich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9586-0163","authenticated-orcid":false,"given":"\u0141ukasz","family":"Ma\u0142ek","sequence":"additional","affiliation":[{"name":"Faculty of Rehabilitation, University of Physical Education, Marymoncka 34, 00-968 Warsaw, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-9756-8842","authenticated-orcid":false,"given":"Piotr","family":"B\u0142aszczak","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Cardinal Wyszynski Hospital, Krasnicka Ave 100, 20-718 Lublin, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"given":"Marta","family":"Kosciuk","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"writing-original-draft","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4125-6585","authenticated-orcid":false,"given":"Janusz","family":"Mysliwiec","sequence":"additional","affiliation":[{"name":"Department of Nuclear Medicine, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"data-curation","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9465-2581","authenticated-orcid":false,"given":"Karol A.","family":"Kaminski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"},{"name":"Department of Population Medicine and Lifestyle Diseases Prevention, Medical University of Bialystok, Curie-Sklodowskiej 24a, 15-276 Bialystok, Poland"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"data-curation","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"3618","DOI":"10.1093\/eurheartj\/ehac237","article-title":"2022 ESC\/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension: Developed by the task force for the diagnosis and treatment of pulmonary hypertension of the European Society of Cardiology (ESC) and the European Respiratory Society (ERS). 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Open"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6672\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T04:29:16Z","timestamp":1788236956000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/17\/6672"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":22,"journal-issue":{"issue":"17","published-online":{"date-parts":[[2026,9]]}},"alternative-id":["jcm15176672"],"URL":"https:\/\/doi.org\/10.3390\/jcm15176672","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]}}}