Evaluation of the Value of 18F-Fluoromisonidazole (18F-FMISO) Positron Emission Tomography Hypoxia Imaging in Idiopathic Pulmonary Fibrosis

Inclusion criteria

For all patients (IPF and healthy volunteers) :

• Person who has given written consent
• Age ≥ 50 years
• Absence of disease, comorbidity, or treatment that may interfere with the evaluation of the study objective, as decided by the investigator

For patients with IPF only:

• Diagnosis of IPF according to the criteria of the current international recommendations (ATS/ERS/JRS/ALAT of 2011) and validated in a multi-disciplinary meeting in a Competence or Reference Center
• Patients who have had a high-resolution thoracic CT scan less than 1 month previously as part of the management of their disease
• Patients who have had a PFT less than 1 month previously as part of the management of their disease

For healthy volunteers only:

• Absence of functional respiratory signs - absence of dyspnea on exertion and at rest and absence of chronic cough.
• Normal clinical examination with no crackles on pulmonary auscultation
• No personal history of chronic hypoxemic respiratory disease

Exclusion criteria

• Person who is not covered by national health insurance
• Cancer or history of cancer in the past 5 years (except basal cell skin cancer)
• Chronic lung disease other than IPF or a history incompatible with the diagnosis of idiopathic pulmonary fibrosis (thoracic radiotherapy, pneumotoxic chemotherapy, etc.)
• Exacerbation of IPF during treatment
• Active smoking
• Patient requiring long-term oxygen therapy (excluding ambulatory oxygen therapy alone)
• Contraindication to PET or CT scan or presence of a condition disturbing the interpretation :

• known allergy to 18F-FMISO
• pregnancy or breastfeeding
• claustrophobia
• uncontrolled type I/II diabetes (HbA1c >7%)
• surgical intervention in the previous month
• Radiotherapy session in the previous 3 months
• concomitant granulomatous condition (sarcoidosis type) or pulmonary inflammation
• Moderate or severe renal insufficiency (GFR < 70 ml/min/1.73 m²)
• Person under legal protection (curatorship, guardianship)
• Adult unable to express consent
• SECONDARY EXCLUSION CRITERIA only for healthy volunteers

• Abnormal 6 min walk test at screening
• Abnormal PFT at screening with FVC ≤ 80% of predicted value and DLCO ≤ 75% of predicted value