PET–CT for visualizing the pathophysiology of COPD in patients with early‐stage NSCLC

SEE PDF] DISCUSSION Herein, we present a case in which PET performed for lung cancer evaluation1 clearly demonstrated FDG uptake in the accessory respiratory muscles, a finding that has been previously reported.2 Patients with COPD often experience skeletal muscle atrophy, which can lead to reduced oxidative capacity and muscle weakening due to the presence of a higher proportion of type 2 muscle fibers compared with type 1 fibers.3 However, this shift toward type 1 fibers is observed in accessory respiratory muscles such as the intercostal muscles.4 The sternocleidomastoid and upper intercostal muscles also play a crucial role in daily respiratory function, unlike the diaphragm and lower intercostal muscles that are affected by airflow limitation.5 Therefore, the different strength of uptake by accessory respiratory muscles revealed by PET–CT highlights the muscle pathophysiology of patients with COPD. CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest. Muscle fibre type shifting in the vastus lateralis of patients with COPD is associated with disease severity: a systematic review and meta‐analysis.