Relationship between Standard Uptake Values of Positron Emission Tomography/Computed Tomography and Salivary Metabolites in Oral Cancer: A Pilot Study.

Shigeo Ishikawa,Kenji Nemoto,Masahiro Sugimoto,Kenichiro Kitabatake,Mitsuyoshi Iino,Tomoyoshi Soga,Kazukuni Kirii,Toshitada Hiraka,Yuuki Toyoguchi,Hiroaki Shimamoto,Masaru Tomita,Masafumi Kanoto,Ayako Sugano

doi:10.3390/jcm9123958

Shigeo Ishikawa, Kenji Nemoto + Show 11 more

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https://doi.org/10.3390/jcm9123958

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Abstract

18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) is usually used for staging or evaluation of treatment response rather than for cancer screening. However, 18F-FDG PET/CT has also been used in Japan for cancer screening in people with no cancer symptoms, and accumulating evidence supports this application of 18F-FDG PET/CT. Previously, we have observed a correlation between the saliva and tumor metabolomic profiles in patients with oral cancer. Hence, if salivary metabolites demonstrate a significant correlation with PET parameters such as the maximum standardized uptake value (SUVmax), they may have the potential to be used as a screening tool before PET/CT to identify patients with high SUVmax. Hence, in this study, we aimed to explore the relationship between salivary metabolites and SUVmax of 18F-FDG PET/CT using previously collected data. 18F-FDG PET/CT was performed for staging 26 patients with oral cancer. The collected data were integrated and analyzed along with quantified salivary hydrophilic metabolites obtained from the same patients with oral cancer and controls (n = 44). In total, 11 metabolites showed significant correlations with SUVmax in the delayed phases. A multiple logistic regression model of the two metabolites showed the ability to discriminate between patients with oral cancer and controls, with an area under the receiver operating characteristic curve of 0.738 (p = 0.001). This study uniquely confirmed a relationship between salivary metabolites and SUVmax of PET/CT in patients with oral cancer; salivary metabolites were significantly correlated with SUVmax. These salivary metabolites can be used as a screening tool before PET/CT to identify patients with high SUVmax, i.e., to detect the presence of oral cancer.

Highlights

18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) is a valuable imaging technique for managing oral cancer [1]. 18F-FDG PET/CT is commonly used for staging and for assessing the therapeutic effect and prognosis of oral cancer [1,2,3,4]
The Warburg effect, a key metabolic mechanism exploited by 18F-FDG PET/CT [5,10], is a cancer-specific metabolic shift manifesting as increased glucose absorption by aerobic glycolysis activation [5,11]
We have previously revealed that salivary metabolites have the potential to discriminate between patients with oral cancer and healthy controls [12,13,14,15], indicating a possible correlation between salivary metabolites and SUVmax

Summary

Introduction

18F-fluorodeoxyglucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) is a valuable imaging technique for managing oral cancer [1]. 18F-FDG PET/CT is commonly used for staging and for assessing the therapeutic effect and prognosis of oral cancer [1,2,3,4]. The maximum standardized uptake value (SUVmax), generated during an integrated 18F-FDG-PET/CT scan, provides information on the metabolic activity of the tumor and is an index that is used to discriminate between malignant lesions and benign lesions. Dual-phase 18F-FDG PET/CT has been used as an alternative method when other types of preoperative imaging cannot clearly distinguish between benign and malignant lesions [6,7,8,9]. Both early and delayed SUVmax values are important for diagnosing malignancy. To the best of our knowledge, no studies have explored this relationship

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