Abstract
BackgroundThis study investigated the relationships between background intestinal uptake on 18F–FDG PET and cardio-metabolic risk (CMR) factors.MethodsA total of 326 female patients that underwent 18F–FDG PET to determine the initial stage of breast cancer were enrolled. None of the patients had history of diabetes or hypertension. The background intestinal uptake on PET was visually graded (low vs. high uptake group) and quantitatively measured using the maximal standardized uptake value (SUVmax). SUVmax of 7 bowel segments (duodenum, jejunum, ileum, cecum, hepatic flexure, splenic flexure, and descending colon-sigmoid junction) were averaged for the total bowel (TB SUVmax). Age, body mass index (BMI), fasting blood glucose level (BST), triglyceride (TG), cholesterol, high density lipoprotein (HDL), and low density lipoprotein (LDL) were the considered CMR factors. The relationships between background intestinal 18F–FDG uptake on PET and diverse CMR factors were analyzed.ResultsThe visual grades based on background intestinal 18F–FDG uptake classified 100 (30.7%) patients into the low uptake group, while 226 (69.3%) were classified into the high uptake group. Among CMR factors, age (p = 0.004), BMI (p<0.001), and TG (p<0.001) were significantly different according to visual grade of background intestinal 18F–FDG uptake. Quantitative TB SUVmax showed significant positive correlation with age (r = 0.203, p<0.001), BMI (r = 0.373, p<0.001), TG (r = 0.338, p<0.001), cholesterol (r = 0.148, p = 0.008), and LDL (r = 0.143, p = 0.024) and significant negative correlation with HDL (r = -0.147, p = 0.022). Multivariate analysis indicated that BMI and TG were independent factors in both visually graded background intestinal 18F–FDG uptake (p = 0.027 and p = 0.023, respectively) and quantitatively measured TB SUVmax (p = 0.006 and p = 0.004, respectively).ConclusionIncreased background intestinal 18F–FDG uptake on PET may suggest alteration of lipid metabolism and risk of cardio-metabolic disease in non-diabetic and non-hypertensive breast cancer patients.
Highlights
Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) is a widely used functional imaging modality for glucose metabolism
This study investigated the relationships between background intestinal uptake on 18F–FDG PET and cardio-metabolic risk (CMR) factors
The visual grades based on background intestinal 18F–FDG uptake classified 100 (30.7%) patients into the low uptake group, while 226 (69.3%) were classified into the high uptake group
Summary
Positron emission tomography (PET) using 18F-fluorodeoxyglucose (FDG) is a widely used functional imaging modality for glucose metabolism. This modality was initially developed for tumor imaging because tumors have a higher 18F-FDG intake than normal cells. There is increased interest in the variable range of physiologic 18F-FDG uptake in normal subjects. The intestine, which is involved in diverse metabolic pathways, presents a variable range of physiologic 18F-FDG uptake. This study investigated the relationships between background intestinal uptake on 18F–FDG PET and cardio-metabolic risk (CMR) factors. Intestinal 18F-FDG Uptake and Lipid Metabolism graded background intestinal 18F–FDG uptake (p = 0.027 and p = 0.023, respectively) and quantitatively measured TB SUVmax (p = 0.006 and p = 0.004, respectively)
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