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Civan C, Ozkan ZG, Ozkan B, Isik EG, Erdogdu E, Has Simsek D, Duman S, Sanli Y, Kara M, Kuyumcu S, Toker A. The Role of [ 18F]FDG PET/CT in the Characterization of Thymic Epithelial Tumors at Initial Stage. Cancer Biother Radiopharm 2024; 39:373-380. [PMID: 38484307 DOI: 10.1089/cbr.2023.0192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Purpose: The aim of this study was to evaluate the potential role of [18F]FDG positron emission tomography/computed tomography (PET/CT) in the characterization of thymic epithelial tumors (TETs). Materials and Methods: A total of 73 patients who underwent preoperative [18F]FDG PET/CT were included in this study. Visual total score (VTS), maximum standard uptake values (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), and heterogeneity index (HI) parameters were analyzed to investigate the prediction of histopathologic grade and advanced stage. Results: The cohort included 26 patients with low-grade thymoma (LGT), 36 patients with high-grade thymoma (HGT), and 11 patients with thymic carcinoma (TC). Ninety-one percent of TC had VTS >2, whereas 31% of LGT and 75% of HGT had VTS >2. SUVmax, MTV, and TLG were statistically significantly higher in the TC group than in both thymoma and HGT. Using the cutoff value of 7.25 for SUVmax, TC was differentiated from thymomas with 91% sensitivity and 74% specificity. TC had significantly lower HI values than thymomas. HI parameters showed good diagnostic ability to differentiate TC from thymoma and TC from HGT. SUVmax, MTV, and TLG were significantly higher in advanced-stage disease than in early-stage disease. Conclusions: Visual and quantitative parameters can reliably predict both advanced disease and the grade of primary tumor in TETs. Therefore, as a promising metabolic imaging method, [18F]FDG PET/CT makes important contributions to preoperative evaluation in routine clinical practice.
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Affiliation(s)
- Caner Civan
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Zeynep Gozde Ozkan
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Berker Ozkan
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Emine Goknur Isik
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Eren Erdogdu
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Duygu Has Simsek
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Salih Duman
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Yasemin Sanli
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Murat Kara
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Serkan Kuyumcu
- Department of Nuclear Medicine and Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
| | - Alper Toker
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul UniversityIstanbul, Türkiye
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Shen X, Zhou X, Yao Y, Meng X, Song Y, Yang Z, Li N. Superiority of [ 68Ga]Ga-DOTA-FAPI-04 PET/CT to [ 18F]FDG PET/CT in the evaluation of thymic epithelial tumours. Eur J Nucl Med Mol Imaging 2023; 50:3414-3424. [PMID: 37316675 DOI: 10.1007/s00259-023-06294-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 06/04/2023] [Indexed: 06/16/2023]
Abstract
PURPOSE The purpose of this study is to compare the ability of [68Ga]Ga-DOTA-FAPI-04 PET/CT and [18F]FDG PET/CT to stratify the malignancy and invasiveness of thymic epithelial tumours (TETs). METHODS From April 2021 to November 2022, participants with suspected TETs confirmed by histopathology or follow-up imaging were prospectively analysed. All participants underwent [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT within 1 week. Clinical characteristics, CT features, and metabolic parameters (maximum standardized uptake value [SUVmax] and tumour-to-mediastinum ratio [TMR]) of subjects with different pathological types and stages were compared. The diagnostic capacities of [18F]FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT were compared using receiver operating characteristic (ROC) curves and McNemar's test. RESULTS Fifty-seven participants were included. [68Ga]Ga-DOTA-FAPI-04 PET/CT was superior to [18F]FDG PET/CT in differentiating thymomas from thymic carcinomas (TCs) (AUC: 0.99 vs. 0.90, P = 0.02). Logistic regression revealed that SUVmax-FAPI (P = 0.04) was a significant predictive factor for TCs. SUVmax-FAPI and TMR-FAPI showed an excellent ability to differentiate low-risk thymomas (types A, AB, and B1), high-risk thymomas (types B2 and B3), and TCs (both P < 0.001). In thymomas, only SUVmax-FAPI (P < 0.001), TMR-FAPI (P < 0.001), and nonsmooth edges (P = 0.02) were significantly higher in the advanced-stage (Masaoka-Koga [MK] stage III/IV) group than in the early-stage group (MK stage I/II). Compared with [18F]FDG PET/CT, [68Ga]Ga-DOTA-FAPI-04 PET/CT showed significantly higher specificity (67% [46 of 69] vs. 93% [64 of 69], P < 0.001) in the detection of lymph node metastases and higher sensitivity (49% [19 of 39] vs. 97% [38 of 39], P < 0.001) in evaluating distant metastases. Both SUVmax-FAPI and TMR-FAPI were correlated with FAP expression (both r = 0.843, P < 0.001). CONCLUSION [68Ga]Ga-DOTA-FAPI-04 PET/CT was superior to [18F]FDG PET/CT in evaluating the World Health Organization (WHO) classification, MK staging, and metastatic status of TETs. TRIAL REGISTRATION ChiCTR2000038080, registration date 2020-09-09, https://www.chictr.org.cn/com/25/showproj.aspx?proj=61192.
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Affiliation(s)
- Xiuling Shen
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Xin Zhou
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Yuan Yao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Xiangxi Meng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Yufei Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Zhi Yang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China
| | - Nan Li
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), NMPA Key Laboratory for Research and Evaluation of Radiopharmaceuticals (National Medical Products Administration), Department of Nuclear Medicine, Peking University Cancer Hospital & Institute, No. 52 Fucheng Rd, Beijing, 100142, China.
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Nakajo M, Takeda A, Katsuki A, Jinguji M, Ohmura K, Tani A, Sato M, Yoshiura T. The efficacy of 18F-FDG-PET-based radiomic and deep-learning features using a machine-learning approach to predict the pathological risk subtypes of thymic epithelial tumors. Br J Radiol 2022; 95:20211050. [PMID: 35312337 PMCID: PMC10996420 DOI: 10.1259/bjr.20211050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2021] [Revised: 02/28/2022] [Accepted: 03/14/2022] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE To examine whether the machine-learning approach using 18-fludeoxyglucose positron emission tomography (18F-FDG-PET)-based radiomic and deep-learning features is useful for predicting the pathological risk subtypes of thymic epithelial tumors (TETs). METHODS This retrospective study included 79 TET [27 low-risk thymomas (types A, AB and B1), 31 high-risk thymomas (types B2 and B3) and 21 thymic carcinomas] patients who underwent pre-therapeutic 18F-FDG-PET/CT. High-risk TETs (high-risk thymomas and thymic carcinomas) were 52 patients. The 107 PET-based radiomic features, including SUV-related parameters [maximum SUV (SUVmax), metabolic tumor volume (MTV), and total lesion glycolysis (TLG)] and 1024 deep-learning features extracted from the convolutional neural network were used to predict the pathological risk subtypes of TETs using six different machine-learning algorithms. The area under the curves (AUCs) were calculated to compare the predictive performances. RESULTS SUV-related parameters yielded the following AUCs for predicting thymic carcinomas: SUVmax 0.713, MTV 0.442, and TLG 0.479 or high-risk TETs: SUVmax 0.673, MTV 0.533, and TLG 0.539. The best-performing algorithm was the logistic regression model for predicting thymic carcinomas (AUC 0.900, accuracy 81.0%), and the random forest (RF) model for high-risk TETs (AUC 0.744, accuracy 72.2%). The AUC was significantly higher in the logistic regression model than three SUV-related parameters for predicting thymic carcinomas, and in the RF model than MTV and TLG for predicting high-risk TETs (each; p < 0.05). CONCLUSION 18F-FDG-PET-based radiomic analysis using a machine-learning approach may be useful for predicting the pathological risk subtypes of TETs. ADVANCES IN KNOWLEDGE Machine-learning approach using 18F-FDG-PET-based radiomic features has the potential to predict the pathological risk subtypes of TETs.
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Affiliation(s)
- Masatoyo Nakajo
- Department of Radiology, Kagoshima University, Graduate School
of Medical and Dental Sciences,
Kagoshima, Japan
| | - Aya Takeda
- Department of General Thoracic Surgery, Kagoshima University,
Graduate School of Medical and Dental Sciences,
Kagoshima, Japan
| | - Akie Katsuki
- Research and Development Department, GE Healthcare
Japan, Tokyo,
Japan
| | - Megumi Jinguji
- Department of Radiology, Kagoshima University, Graduate School
of Medical and Dental Sciences,
Kagoshima, Japan
| | - Kazuyuki Ohmura
- Research and Development Department, GE Healthcare
Japan, Tokyo,
Japan
| | - Atsushi Tani
- Department of Radiology, Kagoshima University, Graduate School
of Medical and Dental Sciences,
Kagoshima, Japan
| | - Masami Sato
- Department of General Thoracic Surgery, Kagoshima University,
Graduate School of Medical and Dental Sciences,
Kagoshima, Japan
| | - Takashi Yoshiura
- Department of Radiology, Kagoshima University, Graduate School
of Medical and Dental Sciences,
Kagoshima, Japan
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Kim K, Jeong JH, Kim SJ. Diagnostic Test Accuracy of 18F-FDG PET or PET/CT for Characterization of Histologic Type of Thymic Epithelial Tumor: A Meta-analysis. Clin Nucl Med 2022; 47:36-42. [PMID: 34661556 DOI: 10.1097/rlu.0000000000003921] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study investigated diagnostic accuracies of 18F-FDG PET or PET/CT for characterization of histologic type of thymic epithelial tumors (TETs) through a systematic review and meta-analysis. PATIENTS AND METHODS The PubMed, Cochrane database, and EMBASE database, from the earliest available date of indexing through August 31, 2020, were searched for studies evaluating diagnostic performance of 18F-FDG PET or PET/CT for characterization of TET. We determined the sensitivities and specificities, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic curves. RESULTS The pooled sensitivity of 18F-FDG PET or PET/CT was 0.89 (95% confidence interval [CI], 0.80-0.95), and the pooled specificity was 0.77 (95% CI, 0.63-0.87) for differentiation between thymic cancer and thymoma. Likelihood ratio syntheses gave an overall positive likelihood ratio (LR+) of 3.9 and negative likelihood ratio (LR-) of 0.14. The pooled diagnostic odds ratio was 28 (95% CI, 13-63). The pooled sensitivity was 0.90 (95% CI, 0.75-0.96), and the pooled specificity was 0.81 (95% CI, 0.68-0.89) for differential diagnosis of a low-risk or high-risk TET. LR+ was 4.7 and LR- was 0.12. The pooled diagnostic odds ratio was 38 (95% CI, 12-121). In meta-regression analysis, no variable was the source of the study heterogeneity. CONCLUSIONS 18F-FDG PET or PET/CT has excellent diagnostic performances for characterization of TET. Further large multicenter studies would be necessary to establish the diagnostic accuracy of 18F-FDG PET or PET/CT for differentiation of histologic type of TET.
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Li Y, Li Y, Huang Y, Wu X, Yang Z, Wu C, Jiang L. Usefulness of 18F-FDG PET/CT in treatment-naive patients with thymic squamous cell carcinoma. Ann Nucl Med 2021; 35:1048-1057. [PMID: 34101153 DOI: 10.1007/s12149-021-01640-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Accepted: 06/07/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Thymic squamous cell carcinoma (TSCC) is very rare. This study aims to investigate the clinical utility of fluorine-18-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) in treatment-naive patients with TSCC. METHODS The tumor metabolic parameters of 18F-FDG PET/CT, including maximum standard uptake value (SUVmax), metabolic tumor volume of primary lesion (MTV-P) and combination of primary lesion and metastases (MTV-C), and total lesion glycolysis of primary lesion (TLG-P) and combination of primary lesion and metastases (TLG-C) were collected. Age, sex, smoking, serum tumor markers, tumor size, Masaoka-Koga stage, TNM stage, contrast-enhanced CT scan, and tumor immunity were also reviewed. Moreover, progression-free survival (PFS) and overall survival (OS) of these patients were analyzed. RESULTS Forty-two treatment-naive patients with TSCC were enrolled in this study. All primary tumors were FDG-avid with the average SUVmax of 10.0 ± 4.5 (range, 1.5-20.4). Higher SUVmax, MTV-C, and TLG-C were observed in advanced Masaoka-Koga stage than early stage, and higher SUVmax was found in advanced TNM stage than early stage. Next, 36 out of 42 patients performed chest contrast-enhanced CT scan, which showed SUVmax associated with the enhancement degree of CT. Moreover, 27 out of 42 lesions were assessed tumor immunity, and the detective rates of PD-L1, PD-1, CD4, CD8, and Foxp3 were 59.3%, 37.0%, 59.3%, 100%, and 77.8%, respectively. Higher SUVmax was observed in lesions with lower CD4-positive tumor-infiltrating lymphocytes. Furthermore, 12- and 24-month PFS and OS rates were 62.0% vs 32.8% and 84.5% vs 68.9%, respectively. Multivariate Cox regression analysis showed that only MTV-C was an independent predictor of PFS. CONCLUSION 18F-FDG PET/CT is useful in evaluating tumor staging, assessing CT enhancement degree, and detecting tumor immunity of TSCC before treatment. 18F-FDG PET/CT could also be a promising tool to provide prognostic information for treatment-naive patients with TSCC.
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Affiliation(s)
- Yuan Li
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China
| | - Yi Li
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China
| | - Yan Huang
- Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China
| | - Xiaodong Wu
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China
| | - Zi Yang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China
| | - Chunyan Wu
- Department of Pathology, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China.
| | - Lei Jiang
- Department of Nuclear Medicine, Shanghai Pulmonary Hospital, Tongji University, 507 Zhengmin Road, Shanghai, 200433, China.
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Meyer HJ, Wienke A, Surov A. Associations between GLUT expression and SUV values derived from FDG-PET in different tumors-A systematic review and meta analysis. PLoS One 2019; 14:e0217781. [PMID: 31206524 PMCID: PMC6576787 DOI: 10.1371/journal.pone.0217781] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 05/19/2019] [Indexed: 12/14/2022] Open
Abstract
PURPOSE Fluorodeoxyglucose-Positron-emission tomography (FDG-PET), quantified by standardized uptake values (SUV), is one of the most used functional imaging modality in clinical routine. It is widely acknowledged to be strongly associated with Glucose-transporter family (GLUT)-expression in tumors, which mediates the glucose uptake into cells. The present systematic review sought to elucidate the association between GLUT 1 and 3 expression with SUV values in various tumors. METHODS MEDLINE library was screened for associations between FDG-PET parameters and GLUT correlation cancer up to October 2018. RESULTS There were 53 studies comprising 2291 patients involving GLUT 1 expression and 11 studies comprising 405 patients of GLUT 3 expression. The pooled correlation coefficient for GLUT 1 was r = 0.46 (95% CI 0.40-0.52), for GLUT 3 was r = 0.35 (95%CI 0.24-0.46). Thereafter, subgroup analyses were performed. The highest correlation coefficient for GLUT 1 was found in pancreatic cancer r = 0.60 (95%CI 0.46-0.75), the lowest was identified in colorectal cancer with r = 0.21 (95% CI -0.57-0.09). CONCLUSION An overall only moderate association was found between GLUT 1 expression and SUV values derived from FDG-PET. The correlation coefficient with GLUT 3 was weaker. Presumably, the underlying mechanisms of glucose hypermetabolism in tumors are more complex and not solely depended on the GLUT expression.
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Affiliation(s)
- Hans-Jonas Meyer
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
| | - Andreas Wienke
- Institute of Medical Epidemiology, Biostatistics, and Informatics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany
| | - Alexey Surov
- Department of Diagnostic and Interventional Radiology, University of Leipzig, Leipzig, Germany
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Ishibashi M, Tanabe Y, Yunaga H, Miyoshi H, Miwa K, Nakamura H, Fujii S, Ogawa T. Usefulness of Preoperative 18F-FDG PET/CT for Patients with Thymic Epithelial Tumors. Yonago Acta Med 2019. [PMID: 30962757 DOI: 10.33160/yam.2019.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
Background The purpose of this study was to investigate the relationship between preoperative FDG-PET parameters and the World Health Organization (WHO) classification or Masaoka staging system of thymic epithelial tumors. Methods We retrospectively reviewed 32 patients with histologically proven thymic epithelial tumors who underwent FDG-PET/CT before surgical resection. FDG-PET parameters, including the maximum standardized uptake value (SUVmax), metabolic tumor volume (MTV), and total lesion glycolytic activity (TLG), were measured. These PET parameters were compared in the Masaoka staging system and WHO classification. A receiver operating characteristics (ROC) analysis was performed to identify the cut-off values of PET parameters for the accurate differentiation of early and advanced stages in the Masaoka staging system. Results There were 17 low-risk thymomas (1 type A, 9 type AB, and 7 type B1), 8 high-risk thymomas (4 type B2 and 4 type B3), and 7 thymic carcinomas (7 squamous cell carcinoma). Their Masaoka stages were as follows: 24 in the early stage (stages I and II) and 8 in the advanced stage (stage III). Regarding the WHO classification, only SUVmax showed a significant difference (P < 0.05). In the Masaoka stage, all PET parameters were significantly higher in the advanced stage than in the early stage (P < 0.05). In the ROC analysis to predict the early and advanced stages in thymic epithelial tumors, the area under the curve was the highest for TLG among the PET parameters examined and the cut-off value of TLG for discriminating the early from advanced stage with maximal sensitivity and specificity was 30.735. Conclusion Although volumetric PET parameters, such as MTV and TLG, did not correlate with the WHO classification, a significant correlation was observed between SUVmax and the WHO classification. In the Masaoka staging system, volumetric PET parameters may achieve more precise staging than SUVmax.
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Affiliation(s)
- Mana Ishibashi
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Yoshio Tanabe
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Hiroto Yunaga
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Hidenao Miyoshi
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Ken Miwa
- †Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Hiroshige Nakamura
- †Division of General Thoracic Surgery, Department of Surgery, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Shinya Fujii
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Toshihide Ogawa
- Division of Radiology, Department of Pathophysiological and Therapeutic Science, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
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Yamamoto M, Inohara H, Nakagawa T. Targeting metabolic pathways for head and neck cancers therapeutics. Cancer Metastasis Rev 2018; 36:503-514. [PMID: 28819926 DOI: 10.1007/s10555-017-9691-z] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cancer cells have distinctive energy metabolism pathways that support their rapid cell division. The preference for anaerobic glycolysis under the normal oxygen condition is known as the Warburg effect and has been observed in head and neck cancers. These metabolic changes are controlled by cancer-related transcription factors, such as tumor suppressor gene and hypoxia inducible factor 1α. In addition, various metabolic enzymes also actively regulate cancer-specific metabolism including the switch between aerobic and anaerobic glycolysis. For a long time, these metabolic changes in cancer cells have been considered a consequence of transformation required to maintain the high rate of tumor cell replication. However, recent studies indicate that alteration of metabolism is sufficient to initiate tumor transformation. Indeed, oncogenic mutations in the metabolic enzymes, isocitrate dehydrogenase and succinate dehydrogenase, have been increasingly found in various cancers, including head and neck cancers. In the present review, we introduce recent findings regarding the cancer metabolism, including the molecular mechanisms of how they affect cancer pathogenesis and maintenance. We also discuss the current and future perspectives on therapeutics that target metabolic pathways, with an emphasis on head and neck cancer.
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Affiliation(s)
- Masashi Yamamoto
- Department of Metabolism and Nutrition, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan.,Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Hidenori Inohara
- Department of Otorhinolaryngology-Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, 565-0871, Japan
| | - Takashi Nakagawa
- Department of Metabolism and Nutrition, Graduate School of Medicine and Pharmaceutical Science for Research, University of Toyama, 2630 Sugitani, Toyama, Toyama, 930-0194, Japan. .,Institute of Natural Medicine, University of Toyama, Toyama, 930-0194, Japan.
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Nakajo M, Jinguji M, Shinaji T, Nakajo M, Aoki M, Tani A, Sato M, Yoshiura T. Texture analysis of 18F-FDG PET/CT for grading thymic epithelial tumours: usefulness of combining SUV and texture parameters. Br J Radiol 2018; 91:20170546. [PMID: 29182373 DOI: 10.1259/bjr.20170546] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVE To retrospectively investigate the standardized uptake value (SUV)-related and heterogeneous texture parameters individually and in combination for differentiating between low- and high-risk 18Fluorone-fludeoxyglucose (18F-FDG)-avid thymic epithelial tumours (TETs) with positron emission tomography (PET)/CT. METHODS SUV-related and 6 texture parameters (entropy, homogeneity, dissimilarity, intensity variability, size-zone variability and zone percentage) were compared between 11 low-risk and 23 high-risk TETs (metabolic tumour volume >10.0 cm3 and SUV ≥2.5). Diagnostic performance was evaluated by receiver operating characteristic analysis. The diagnostic value of combining SUV and texture parameters was examined by a scoring system. RESULTS High-risk TETs were significantly higher in SUVmax (p = 0.022), entropy (p = 0.038), intensity variability (p = 0.041) and size-zone variability (p = 0.045) than low-risk TETs. Diagnostic accuracies of these 4 parameters, dissimilarity and zone percentage which also showed significance in receiver operating characteristic analysis ranged between 64.7 and 73.5% without significant differences in AUC (range; 0.71 to 0.75) (p ≥ 0.05 each). Each parameter was scored as 0 (negative for high-risk) or 1 (positive for high-risk) according to each threshold criterion, then scores were summed [0 or 1 for low-risk TETs (median; 1); ≥2 for high-risk TETs (median; 4)]. The sensitivity, specificity and accuracy of detecting high-risk TETs were 100, 81.8 and 94.1%, respectively, with an AUC of 0.99. CONCLUSION The diagnostic performances of individual SUVmax and texture parameters were relatively low. However, combining these parameters can significantly increase diagnostic performance when differentiating between relatively large low- and high-risk 18F-FDG-avid TETs. Advances in knowledge: Combined use of SUVmax and texture parameters can significantly increase the diagnostic performance when differentiating between low- and high-risk TETs.
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Affiliation(s)
- Masatoyo Nakajo
- 1 Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Megumi Jinguji
- 1 Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Tetsuya Shinaji
- 2 Department of Nuclear Medicine, University of Würzburg , Würzburg , Germany
| | - Masayuki Nakajo
- 3 Department of Radiology, Nanpuh Hospital , Kagoshima , Japan
| | - Masaya Aoki
- 4 Department of Thoracic Surgery, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Atsushi Tani
- 1 Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Masami Sato
- 4 Department of Thoracic Surgery, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
| | - Takashi Yoshiura
- 1 Department of Radiology, Kagoshima University, Graduate School of Medical and Dental Sciences , Kagoshima , Japan
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SLC2A1/GLUT1 expression in mural nodules of intraductal papillary mucinous neoplasm of the pancreas. Hum Pathol 2017; 65:71-78. [PMID: 28412205 DOI: 10.1016/j.humpath.2017.03.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/30/2016] [Revised: 03/03/2017] [Accepted: 03/12/2017] [Indexed: 10/19/2022]
Abstract
In intraductal papillary mucinous neoplasms (IPMNs), the presence of a mural nodule showing a papillary or nodular proliferation of tumor cells in the dilated pancreatic duct is an indication for resection of IPMN. Solute carrier family 2, facilitated glucose transporter member 1, known as glucose transporter type 1 (SLC2A1/GLUT1) mediates cellular glucose uptake in many carcinomas and is correlated with increased 18F-fluorodeoxyglucose (18F-FDG) uptake. We examined SLC2A1/GLUT1 expression in the mural nodules of 180 IPMN specimens to distinguish malignant/benign tumors. A mural nodule was detected in 80 (44.4%) of the IPMNs, and was detected in 18.6% (13/70) of the IPMN-low (dysplasia) specimens, 36.1% (13/36) of the IPMN-int, 93.3% (28/30) of the IPMN-high, and 59.1% (26/44) of the IPMN-inv (with an associated invasive carcinoma) specimens. The sensitivity for detecting mural nodules was 81.7% by endoscopic ultrasonography, 70% by contrast-enhanced computed tomography and 54% by endoscopic retrograde cholangiopancreatography. SLC2A1/GLUT1 expression in the mural nodules was recognized in the basal and basolateral cytomembrane of tumor cells and was expressed in 15.4% (2/13) of the IPMN-low, 15.4% (2/13) of the IPMN-int, 71.4% (20/28) of the IPMN-high and 84.6% (22/26) of the IPMN-inv groups. The SLC2A1/GLUT1 expression was significantly higher in the IPMN-high and IPMN-inv mural nodules than in those of the IPMN-low and IPMN-int groups. Our findings suggest that SLC2A1/GLUT1 is expressed late in the adenoma-carcinoma sequence during carcinogenesis in IPMN, and SLC2A1/GLUT1 act as therapeutic target for malignant IPMN.
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Segreto S, Fonti R, Ottaviano M, Pellegrino S, Pace L, Damiano V, Palmieri G, Del Vecchio S. Evaluation of metabolic response with 18F-FDG PET-CT in patients with advanced or recurrent thymic epithelial tumors. Cancer Imaging 2017; 17:10. [PMID: 28264726 PMCID: PMC5339950 DOI: 10.1186/s40644-017-0112-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2016] [Accepted: 02/24/2017] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Patients with advanced or recurrent thymic epithelial tumors (TETs) often need several consecutive lines of chemotherapy. The aim of this retrospective monocentric study was to test whether 18F-Fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is able to monitor standard chemotherapy efficacy in those patients and whether metabolic response correlates with morphovolumetric response as assessed by Response Evaluation Criteria in Solid Tumor (RECIST). METHODS We evaluated 27 consecutive patients with advanced (16 patients) or recurrent (11 patients) TETs. All patients underwent 18F-FDG PET-CT before and after at least 3 cycles of chemotherapy. Maximum standardized uptake value (SUVmax) of all detected lesions was recorded and the most 18F-FDG avid lesion in each patient was selected for determination of percentage change of SUVmax (ΔSUVmax) in pre- and post-treatment scans. Tumor response was assessed by contrast-enhanced computed tomography (CE-CT) using RECIST criteria. Receiver operating characteristic (ROC) curve analysis was performed to define the optimal threshold of ΔSUVmax discriminating responders from non-responders. RESULTS Metabolic response expressed as ΔSUVmax was significantly correlated with morphovolumetric response (Spearman's rank correlation, r = 0.64, p = 0.001). ROC curve analysis showed that a ΔSUVmax value of -25% could discriminate responders from non-responders with a sensitivity of 88% and a specificity of 80%. Conversely, basal SUVmax values were not predictive of morphovolumetric tumor response. CONCLUSIONS Our findings indicate that metabolic response assessed by 18F-FDG PET-CT, through evaluation of ΔSUVmax, may allow identification of responders and non-responders thus guiding adaptation of therapy in patients with advanced or recurrent TETs.
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Affiliation(s)
- Sabrina Segreto
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Edificio 10, 80131, Naples, Italy
| | - Rosa Fonti
- Institute of Biostructures and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy
| | - Margaret Ottaviano
- Rare Tumors Reference Center, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Sara Pellegrino
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Edificio 10, 80131, Naples, Italy
| | - Leonardo Pace
- Department of Medicine and Surgery, University of Salerno, Via S. Allende, 84081, Baronissi, Salerno, Italy
| | - Vincenzo Damiano
- Rare Tumors Reference Center, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Giovannella Palmieri
- Rare Tumors Reference Center, University of Naples Federico II, Via S. Pansini 5, 80131, Naples, Italy
| | - Silvana Del Vecchio
- Department of Advanced Biomedical Sciences, University of Naples Federico II, Via Pansini 5, Edificio 10, 80131, Naples, Italy. .,Institute of Biostructures and Bioimaging, National Research Council, Via T. De Amicis 95, 80145, Naples, Italy.
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Kitami A, Sano F, Ohashi S, Suzuki K, Uematsu S, Suzuki T, Kadokura M. The Usefulness of Positron-Emission Tomography Findings in the Management of Anterior Mediastinal Tumors. Ann Thorac Cardiovasc Surg 2017; 23:26-30. [PMID: 28123154 PMCID: PMC5347484 DOI: 10.5761/atcs.oa.16-00205] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Accepted: 11/07/2016] [Indexed: 11/16/2022] Open
Abstract
PURPOSE We performed a retrospective analysis to evaluate the usefulness of positron-emission tomography/computed tomography (PET/CT) findings in the classification and management of anterior mediastinal tumors. METHODS Between 2006 and 2015, 105 patients with anterior mediastinal tumor received PET/CT. 18F-fluorodeoxyglucose (18F-FDG)-PET images were obtained 60 minutes after the injection of 18F-FDG. RESULTS The histological classifications were as follows: thymoma (n = 49), thymic carcinoma (TC) (n = 19), malignant lymphoma (ML) (n = 8), teratoma (n = 7), thymic cyst (n = 14), and others (n = 8). Upon visual inspection (SUV max: >2.0), all of the malignant tumors showed 18F-FDG accumulation (with the exception of one type A thymoma). Two of the 14 thymic cysts and three of the seven teratomas showed slight 18F-FDG accumulation. The SUV max values of the low-grade thymomas, high-grade thymomas, TCs and MLs were 3.14 ± 0.73, 4.34 ± 1.49, 8.59 ± 3.05, and 10.08 ± 2.53, respectively, with significant differences between the low- and high-grade thymomas, and between TCs and MLs. The sensitivity, specificity and accuracy of 18F-FDG in the detection of low-grade thymomas and thymomas with a maximum diameter of ≤50 mm and an SUV max of ≤3.4 were 85%, 48%, and 60%, respectively. CONCLUSION FDG-PET/CT is an objective and useful modality in the differential diagnosis and management of anterior mediastinal tumors.
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Affiliation(s)
- Akihiko Kitami
- Respiratory Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Kanagawa, Japan
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Yang HJ, Xu WJ, Guan YH, Zhang HW, Ding WQ, Rong L, Qiu ZB, Zhong L. Expression of Glut-1 and HK-II in Pancreatic Cancer and Their Impact on Prognosis and FDG Accumulation. Transl Oncol 2016; 9:583-591. [PMID: 27916293 PMCID: PMC5143352 DOI: 10.1016/j.tranon.2016.08.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Accepted: 08/09/2016] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE: The purpose of this article is to analyze the expression of Glut-1 and HK-II, the association between their expression and 18F-FDG accumulation in pancreatic cancer. METHODS: Fifty patients with histologically proven pancreatic cancer were included in this preliminary study, all of whom received 18F-FDG PET/CT performance before surgery. Immunohistochemical staining of tumor tissue and adjacent normal tissue was performed for Glut-1 and HK-II. By combining proportions and intensity of immunochemical staining, we obtained the modified immunohistological scores for Glut-1 and HK-II respectively. The relationship between expression of Glut-1, HK-II and series of parameters was analyzed, i.e. clinicopathological characteristics, prognosis of patients and SUVmax of PET-CT. RESULTS: Compared with normal tissue, the Glut-1 and HK-II expression in pancreatic cancer tissue was significantly increased (P < .001). There was no correlation between expression of Glut-1, HK-II and age, gender, tumor size, tumor location, tumor histological type, tumor differentiation, the nerve infiltration, vascular invasion, local infiltration, lymph node metastasis or tumor staging in pancreatic cancer (P > .05). During the follow-up period, the survival curves of low Glut-1 group and high Glut-1 group were statistically different (P = .049). Multivariate analysis (Cox regression) revealed that Glut-1 expression was not associated with mortality (P > .05). No statistical difference was found in the survival curves of negative HK-II group and positive HK-II group (P = .545). There was no correlation between 18F-FDG uptake and expression of Glut-1 and HK-II(P > .05). CONCLUSION: The Glut-1 and HK-II expression in pancreatic cancer tissue was significantly increased. There was no correlation between expression of Glut-1, HK-II and clinicopathological characteristics, prognosis and 18F-FDG uptake.
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Affiliation(s)
- Hai-Jing Yang
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China.
| | - Wei-Jia Xu
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China.
| | - Yi-Hui Guan
- PET Center of Huashan Hospital, Fudan University, 518 Wuzhong East Road, Shanghai 200235, China
| | - Hui-Wei Zhang
- PET Center of Huashan Hospital, Fudan University, 518 Wuzhong East Road, Shanghai 200235, China
| | - Wei-Qun Ding
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China
| | - Lan Rong
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China
| | - Zhi-Bing Qiu
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China
| | - Liang Zhong
- Department of Gastroenterology, Huashan Hospital, Fudan University, 12 Wulumuqi Middle Road, Shanghai 200040, China.
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Thomas de Montpréville V, Quilhot P, Chalabreysse L, De Muret A, Hofman V, Lantuéjoul S, Parrens M, Payan MJ, Rouquette I, Secq V, Girard N, Besse B, Marx A, Molina TJ. Glut-1 intensity and pattern of expression in thymic epithelial tumors are predictive of WHO subtypes. Pathol Res Pract 2015; 211:996-1002. [DOI: 10.1016/j.prp.2015.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 10/16/2015] [Indexed: 11/26/2022]
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15
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Jeon JY, Lee H, Park J, Lee M, Park SW, Kim JS, Lee M, Cho B, Kim K, Choi AMK, Kim CK, Yun M. The regulation of glucose-6-phosphatase and phosphoenolpyruvate carboxykinase by autophagy in low-glycolytic hepatocellular carcinoma cells. Biochem Biophys Res Commun 2015; 463:440-6. [PMID: 26036577 DOI: 10.1016/j.bbrc.2015.05.103] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2015] [Accepted: 05/29/2015] [Indexed: 11/20/2022]
Abstract
The glycolytic phenotype is a dominant metabolic phenomenon in cancer and is reflected in becoming aggressive. Certain hepatocellular carcinoma lack increased glycolysis and prefer to uptake acetate than glucose for metabolism. Autophagy plays a role in preserving energies and nutrients when there is limited external nutrient supply and maintains glucose level of blood though supporting gluconeogenesis in the liver. As the role of autophagy and gluconeogenesis in HCC following the glycolic activity was not clear, we cultured HCC cells with different glycolytic levels in Hank's balanced salt solution (HBSS) to induce autophagy and conducted the activity of gluconeogenesis. Both autophagy and gluconeogenesis were induced in low glycolytic HCC cells (HepG2). In glycolytic Hep3B cells, only autophagy without gluconeogenesis was induced upon starvation. When autophagy was blocked, the level of glucose-6-phosphatase (G6Pase) and phosphoenolpyruvate carboxykinase (PEPCK) was reduced in HepG2 cells and not in Hep3B. Altogether, we investigated contribution of hepatic gluconeogenesis to the metabolic phenotype of HCC cells and the role of autophagy as a potential mechanism regulating gluconeogenesis in low glycolytic HCC.
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Affiliation(s)
- Jeong Yong Jeon
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Hyangkyu Lee
- Department of Clinical Nursing Science, Yonsei University College of Nursing, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Jeayeo Park
- Department of Clinical Nursing Science, Yonsei University College of Nursing, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Misu Lee
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Sae Whan Park
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Ji Sook Kim
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Milim Lee
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Byoungchul Cho
- Division of Medical Oncology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Kyungsup Kim
- Department of Biochemistry and Molecular Biology, Brain Korea 21 Project for Medical Science, Institute of Genetic Science, Integrated Genomic Research Center for Metabolic Regulation, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea
| | - Augustine M K Choi
- Joan and Sanford I. Weill Department of Medicine, Weill Cornell Medical College and New York-Presbyterian Hospital, New York, NY, USA
| | - Chun K Kim
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02026, USA.
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-gu, Seoul 120-752, South Korea.
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Sato N, Nakamura Y, Takanami K, Ono Y, Omata K, Morimoto R, Satoh F, Ise K, Yamada S, Kasajima A, Fujishima F, Watanabe M, Arai Y, Sasano H. Case report: adrenal oncocytoma associated with markedly increased FDG uptake and immunohistochemically positive for GLUT1. Endocr Pathol 2014; 25:410-5. [PMID: 25284122 DOI: 10.1007/s12022-014-9337-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Usually, benign tumors are not associated with an increased F-18 fluorodeoxyglucose (F-18 FDG) uptake on positron emission tomography (PET), although some exceptions have been reported in adrenal neoplasms. We present a rare case of adrenocortical oncocytoma associated with markedly increased FDG uptake, demonstrating a maximum standardized uptake value of 46.8. Histological examination demonstrated diffuse proliferation of tumor cells with eosinophilic and granular cytoplasm that were diffusely immunopositive for mitochondria and glucose transport protein 1, with focal and weak immunopositivity for 3β-hydroxysteroid dehydrogenase. Ultrastructural examination also revealed abundant mitochondria in the tumor cells. The tumor was diagnosed as adrenocortical oncocytoma and was considered benign according to Lin-Weiss-Bisceglia criteria. Diagnosis of adrenocortical oncocytoma can pose difficulties during both preoperative radiological and postoperative histopathological investigations.
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Affiliation(s)
- Naomi Sato
- Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan
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Treglia G, Sadeghi R, Giovanella L, Cafarotti S, Filosso P, Lococo F. Is (18)F-FDG PET useful in predicting the WHO grade of malignancy in thymic epithelial tumors? A meta-analysis. Lung Cancer 2014; 86:5-13. [PMID: 25175317 DOI: 10.1016/j.lungcan.2014.08.008] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2014] [Revised: 08/10/2014] [Accepted: 08/11/2014] [Indexed: 12/27/2022]
Abstract
AIM To perform a systematic review and meta-analysis of published data on the role of fluorine-18-fluorodeoxyglucose positron emission tomography ((18)F-FDG PET) in predicting the WHO grade of malignancy in thymic epithelial tumors (TETs). METHODS A comprehensive literature search of studies published up to March 2014 was performed. Data on maximum standardized uptake value (SUVmax) in patients with low-risk thymomas (A, AB, B1), high-risk thymomas (B2, B3) and thymic carcinomas (C) according to the WHO classification were collected when reported by the retrieved articles. The comparison of mean SUVmax between low-risk thymomas, high-risk thymomas and thymic carcinomas was expressed as weighted mean difference (WMD) and a pooled WMD was calculated including 95% confidence interval (95%CI). RESULTS Eleven studies were selected for the meta-analysis. The pooled WMD of SUVmax between high-risk and low-risk thymomas was 1.2 (95%CI: 0.4-2.0). The pooled WMD of SUVmax between thymic carcinomas and low-risk thymomas was 4.8 (95%CI: 3.4-6.1). Finally, the pooled WMD of SUVmax between thymic carcinomas and high-risk thymomas was 3.5 (95%CI: 2.7-4.3). CONCLUSIONS (18)F-FDG PET may predict the WHO grade of malignancy in TETs. In particular, we demonstrated a statistically significant difference of SUVmax between the different TETs (low-grade thymomas, high-grade thymomas and thymic carcinomas).
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Affiliation(s)
- Giorgio Treglia
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Ramin Sadeghi
- Nuclear Medicine Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Luca Giovanella
- Department of Nuclear Medicine and PET/CT Center, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland
| | - Stefano Cafarotti
- Unit of Thoracic Surgery, San Giovanni Hospital, Bellinzona, Switzerland
| | | | - Filippo Lococo
- Unit of Thoracic Surgery, IRCCS-Arcispedale Santa Maria Nuova, Reggio Emilia, Italy.
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Salavati A, Saboury B, Alavi A. Comment on: “Tumor Aggressiveness and Patient Outcome in Cancer of the Pancreas Assessed by Dynamic 18F-FDG PET/CT”. J Nucl Med 2013; 55:350-1. [DOI: 10.2967/jnumed.113.130138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Lococo F, Cesario A, Okami J, Cardillo G, Cavuto S, Tokunaga T, Apolone G, Margaritora S, Granone P. Role of combined 18F-FDG-PET/CT for predicting the WHO malignancy grade of thymic epithelial tumors: A multicenter analysis. Lung Cancer 2013; 82:245-51. [DOI: 10.1016/j.lungcan.2013.08.003] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2013] [Revised: 07/09/2013] [Accepted: 08/01/2013] [Indexed: 10/26/2022]
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Krasnov GS, Dmitriev AA, Lakunina VA, Kirpiy AA, Kudryavtseva AV. Targeting VDAC-bound hexokinase II: a promising approach for concomitant anti-cancer therapy. Expert Opin Ther Targets 2013; 17:1221-33. [DOI: 10.1517/14728222.2013.833607] [Citation(s) in RCA: 104] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Toba H, Kondo K, Sadohara Y, Otsuka H, Morimoto M, Kajiura K, Nakagawa Y, Yoshida M, Kawakami Y, Takizawa H, Kenzaki K, Sakiyama S, Bando Y, Tangoku A. 18F-fluorodeoxyglucose positron emission tomography/computed tomography and the relationship between fluorodeoxyglucose uptake and the expression of hypoxia-inducible factor-1 , glucose transporter-1 and vascular endothelial growth factor in thymic epithelial tumours. Eur J Cardiothorac Surg 2013; 44:e105-12. [DOI: 10.1093/ejcts/ezt263] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
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Combined Imaging With 18F-FDG-PET/CT and 111In-Labeled Octreotide SPECT for Evaluation of Thymic Epithelial Tumors. Clin Nucl Med 2013; 38:354-8. [DOI: 10.1097/rlu.0b013e318286bd84] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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Thomas A, Mena E, Kurdziel K, Venzon D, Khozin S, Berman AW, Choyke P, Szabo E, Rajan A, Giaccone G. 18F-fluorodeoxyglucose positron emission tomography in the management of patients with thymic epithelial tumors. Clin Cancer Res 2013; 19:1487-93. [PMID: 23382114 PMCID: PMC3602145 DOI: 10.1158/1078-0432.ccr-12-2929] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE There are limited data regarding the role of (18)F-fluorodeoxyglucose positron emission tomography ([(18)F]-FDG PET) imaging in management of patients with thymic epithelial tumors (TET). The primary objective of this study was to assess the usefulness of early [(18)F]-FDG PET to monitor treatment efficacy and its correlation with Response Evaluation Criteria in Solid Tumors (RECIST) in patients with TETs. EXPERIMENTAL DESIGN [(18)F]-FDG PET/computed tomographic (CT) scans were conducted at baseline and after 6 weeks of treatment in patients enrolled in two phase II and one phase I/II clinical trials. On the basis of data from other solid tumors, metabolic response was defined as a reduction of [(18)F]-FDG uptake by more than 30% as assessed by average standardized uptake values (SUV) of up to five most metabolically active lesions. RESULTS Fifty-six patients with unresectable Masaoka stage III or IV TETs were included. There was a close correlation between early metabolic response and subsequent best response using RECIST (P < 0.0001-0.0003): sensitivity and specificity for prediction of best response were 95% and 100%, respectively. Metabolic responders had significantly longer progression-free survival (median, 11.5 vs. 4.6 months; P = 0.044) and a trend toward longer overall survival (median, 31.8 vs. 18.4 months; P = 0.14) than nonresponders. [(18)F]-FDG uptake was significantly higher in thymic carcinoma than in thymoma (P = 0.0004-0.0010). CONCLUSION In patients with advanced TETs, early metabolic response closely correlates with outcome of therapy. [(18)F]-FDG PET may be used to monitor treatment efficacy and assess histologic differences in patients with advanced TETs.
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Affiliation(s)
- Anish Thomas
- Medical Oncology Branch, National Cancer Institute, Bethesda, MD
| | - Esther Mena
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD
| | - Karen Kurdziel
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD
| | - David Venzon
- Biostatistics and Data Management Section, National Cancer Institute, Bethesda, MD
| | - Sean Khozin
- Medical Oncology Branch, National Cancer Institute, Bethesda, MD
| | - Arlene W. Berman
- Medical Oncology Branch, National Cancer Institute, Bethesda, MD
| | - Peter Choyke
- Molecular Imaging Program, National Cancer Institute, Bethesda, MD
| | - Eva Szabo
- Division of Cancer Prevention, National Cancer Institute, Bethesda, MD
| | - Arun Rajan
- Medical Oncology Branch, National Cancer Institute, Bethesda, MD
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Rakheja D, Khokhar S, Mitui M, Cost NG. Immunohistochemical expression of GLUT1 and its correlation with unfavorable histology and TP53 codon 72 polymorphism in Wilms tumors. Pediatr Dev Pathol 2012; 15:286-92. [PMID: 22483234 DOI: 10.2350/12-01-1151-oa.1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Reprogramming of energy metabolism, such as increased glycolysis, is a hallmark of cancer cells. One mechanism by which cancer cells fuel glycolysis is through increased uptake of glucose across cell membranes via the glucose transporter GLUT1. One of the transcriptional repressors of GLUT1 is wild-type TP53, and cancer-associated loss of function mutations within the DNA-binding domain of TP53 impairs the repressive effect of TP53 on transcriptional activity of the GLUT1 gene promoter. Because TP53 mutations are associated with unfavorable histology (diffuse anaplasia) in Wilms tumors, we hypothesized increased expression of GLUT1 in these tumors. To evaluate this hypothesis, we performed tissue microarray-based immunohistochemistry for GLUT1 in a set of 50 Wilms tumors, including 5 with unfavorable histology. In a subset of 16 favorable histology Wilms tumors, we compared the GLUT1 immunoexpression with TP53 codon 72 polymorphism status. We found consistently stronger immunoexpression of GLUT1 in unfavorable histology Wilms tumors compared to favorable histology Wilms tumors (P = 0.04). We noted that the favorable histology Wilms tumors with a proline residue at position 72 of TP53 tended to have higher immunoexpression of GLUT1, although this immunoexpression did not reach statistical significance in this small set of cases. In summary, our finding of strong GLUT1 immunoexpression in unfavorable histology Wilms tumors indicates that these tumors are likely to be 2-deoxy-2-((18)F)fluoro-d-glucose avid and that GLUT1 should be evaluated as a therapeutic target for these tumors that otherwise show resistance to conventional therapy.
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Affiliation(s)
- Dinesh Rakheja
- Department of Pathology, Children's Medical Center, Dallas, TX, USA.
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Marsboom G, Wietholt C, Haney CR, Toth PT, Ryan JJ, Morrow E, Thenappan T, Bache-Wiig P, Piao L, Paul J, Chen CT, Archer SL. Lung ¹⁸F-fluorodeoxyglucose positron emission tomography for diagnosis and monitoring of pulmonary arterial hypertension. Am J Respir Crit Care Med 2012; 185:670-9. [PMID: 22246173 DOI: 10.1164/rccm.201108-1562oc] [Citation(s) in RCA: 135] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
RATIONALE Pulmonary arterial hypertension (PAH) is a proliferative arteriopathy associated with glucose transporter-1 (Glut1) up-regulation and a glycolytic shift in lung metabolism. Glycolytic metabolism can be detected with the positron emission tomography (PET) tracer (18)F-fluorodeoxyglucose (FDG). OBJECTIVES The precise cell type in which glycolytic abnormalities occur in PAH is unknown. Moreover, whether FDG-PET is sufficiently sensitive to monitor PAH progression and detect therapeutic regression is untested. We hypothesized that increased lung FDG-PET reflects enhanced glycolysis in vascular cells and is reversible in response to effective therapies. METHODS PAH was induced in Sprague-Dawley rats by monocrotaline or chronic hypoxia (10% oxygen) in combination with Sugen 5416. Monocrotaline rats were treated with oral dichloroacetate or daily imatinib injections. FDG-PET scans and pulmonary artery acceleration times were obtained weekly. The origin of the PET signal was assessed by laser capture microdissection of airway versus vascular tissue. Metabolism was measured in pulmonary artery smooth muscle cell (PASMC) cultures, using a Seahorse extracellular flux analyzer. MEASUREMENTS AND MAIN RESULTS Lung FDG increases 1-2 weeks after monocrotaline (when PAH is mild) and is normalized by dichloroacetate and imatinib, which both also regress medial hypertrophy. Glut1 mRNA is up-regulated in both endothelium and PASMCs, but not airway cells or macrophages. PASMCs from monocrotaline rats are hyperproliferative and display normoxic activation of hypoxia-inducible factor-1α (HIF-1α), which underlies their glycolytic phenotype. CONCLUSIONS HIF-1α-mediated Glut1 up-regulation in proliferating vascular cells in PAH accounts for increased lung FDG-PET uptake. FDG-PET is sensitive to mild PAH and can monitor therapeutic changes in the vasculature.
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Affiliation(s)
- Glenn Marsboom
- Section of Cardiology, Department of Medicine, University of Chicago, Chicago, IL 60637, USA
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Otsuka H. The utility of FDG-PET in the diagnosis of thymic epithelial tumors. THE JOURNAL OF MEDICAL INVESTIGATION 2012; 59:225-34. [DOI: 10.2152/jmi.59.225] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Hideki Otsuka
- Department of Medical Imaging, Institute of Health Biosciences, Tokushima University Graduate School
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Kaira K, Sunaga N, Ishizuka T, Shimizu K, Yamamoto N. The role of [¹⁸F]fluorodeoxyglucose positron emission tomography in thymic epithelial tumors. Cancer Imaging 2011; 11:195-201. [PMID: 22138614 PMCID: PMC3266585 DOI: 10.1102/1470-7330.2011.0028] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/13/2011] [Indexed: 12/16/2022] Open
Abstract
The purpose of this study was to systemically review the available literature regarding the diagnostic performance of positron emission tomography (PET) using 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) in patients with thymic epithelial tumors. We reviewed 13 studies that evaluated the diagnostic role of thymic epithelial tumors with [18F]FDG-PET. [18F]FDG-PET is a useful radiological modality for differentiating between thymomas and thymic carcinoma. However, [18F]FDG-PET may not be useful for differentiating low-risk thymoma and high-risk thymoma. One paper reported that [18F]FDG-PET has a predictive significance for treatment and prognosis in thymic epithelial tumors. Two papers reported that the degree of [18F]FDG uptake in thymic epithelial tumors is based on glucose metabolism. [18F]FDG-PET may have a further use for radiological differential diagnosis of thymomas and thymic carcinomas.
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Affiliation(s)
- Kyoichi Kaira
- Division of Thoracic Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
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Carvalho KC, Cunha IW, Rocha RM, Ayala FR, Cajaíba MM, Begnami MD, Vilela RS, Paiva GR, Andrade RG, Soares FA. GLUT1 expression in malignant tumors and its use as an immunodiagnostic marker. Clinics (Sao Paulo) 2011; 66:965-72. [PMID: 21808860 PMCID: PMC3129958 DOI: 10.1590/s1807-59322011000600008] [Citation(s) in RCA: 158] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2011] [Accepted: 02/28/2011] [Indexed: 12/18/2022] Open
Abstract
OBJECTIVE To analyze glucose transporter 1 expression patterns in malignant tumors of various cell types and evaluate their diagnostic value by immunohistochemistry. INTRODUCTION Glucose is the major source of energy for cells, and glucose transporter 1 is the most common glucose transporter in humans. Glucose transporter 1 is aberrantly expressed in several tumor types. Studies have implicated glucose transporter 1 expression as a prognostic and diagnostic marker in tumors, primarily in conjunction with positron emission tomography scan data. METHODS Immunohistochemistry for glucose transporter 1 was performed in tissue microarray slides, comprising 1955 samples of malignant neoplasm from different cell types. RESULTS Sarcomas, lymphomas, melanomas and hepatoblastomas did not express glucose transporter 1. Forty-seven per cent of prostate adenocarcinomas were positive, as were 29% of thyroid, 10% of gastric and 5% of breast adenocarcinomas. Thirty-six per cent of squamous cell carcinomas of the head and neck were positive, as were 42% of uterine cervix squamous cell carcinomas. Glioblastomas and retinoblastomas showed membranous glucose transporter 1 staining in 18.6% and 9.4% of all cases, respectively. Squamous cell carcinomas displayed membranous expression, whereas adenocarcinomas showed cytoplasmic glucose transporter 1 expression. CONCLUSION Glucose transporter 1 showed variable expression in various tumor types. Its absence in sarcomas, melanomas, hepatoblastomas and lymphomas suggests that other glucose transporters mediate the glycolytic pathway in these tumors. The data suggest that glucose transporter 1 is a valuable immunohistochemical marker that can be used to identify patients for evaluation by positron emission tomography scan. The function of cytoplasmic glucose transporter 1 in adenocarcinomas must be further examined.
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Affiliation(s)
- Kátia C Carvalho
- Departament of Obstetrics and Gynecology, Faculdade de Medicina, Universidade de São Paulo, SP, Brazil.
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