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. 2021 Feb 13;48(10):3058–3074. doi: 10.1007/s00259-021-05209-2

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© The Author(s) 2021

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 6 — [¹⁸F]FMISO PET can detect advanced lung fibrosis and is suitable for anti-fibrotic therapies follow-up. a Representative [¹⁸F]FMISO PET/CT images of NaCl- and BLM-receiving mice treated or not with nintedanib or pirfenidone at D0, D9, D16 and D23. Graph represents evolution of [¹⁸F]FMISO lung uptake (%IG/g) at all time points. Results are presented as mean ± SEM, n = 4 for NaCl and n = 5 for other groups. Stars (*) are representative of statistical comparison between time points for each group and hashes (#) are representative of statistical comparison between the groups at each time points. **^(##)p < 0.01. Black arrow represents the start of treatments. b Radioactivity content in lungs of NaCl- and BLM-receiving mice treated or not with nintedanib or pirfenidone and lung to blood ratio at D23 measured ex vivo with a γ-counter. Results are presented as mean ± SEM, n = 4 for NaCl and n = 5 for other groups. Stars (*) are representative of comparison of each group with NaCl group and hashes (#) are representative of statistical comparison of each group with the BLM group, *^(#)p < 0.05 and ^##p < 0.01. c Representative 3D reconstruction of lung 3DROI segmentation of PET images representative of hypoxic lung volume (HLV) of BLM-receiving mice treated or not with nintedanib or pirfenidone at D0, D9, D16 and D23. Cyan represents areas with high [¹⁸F]FMISO lung uptake (above threshold of HLV_threshold = TBR × 1.4); grey represents areas with low [¹⁸F]FMISO lung uptake (below the threshold). Graph represents the percentage of evolution of HLV. Results are presented as mean ± SEM, n = 4 for NaCl and n = 5 for other groups. Stars (*) are representative of statistical comparison between time points for each group and hashes (#) are representative of statistical comparison between the groups at each time points. **^(##)p < 0.01. Black arrow represents the start of treatments. d Graph represents the evolution of [¹⁸F]FMISO lung uptake in %ID/g of BLM-receiving mice treated or not with nintedanib or pirfenidone at D0, D9, D16 and D23 in aerated and non-aerated lung areas (segmented on CT images). Results are presented as mean ± SEM, n = 4 for NaCl and n = 5 for other groups. Black arrow represents the start of treatments