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Lodeweyckx T, de Hoon J, Van Laere K, Bautista E, Rizzo G, Bishop C, Rabiner E, Martin RS, Ford A, Vargas G. Effects on cerebral blood flow after single doses of the β 2 agonist, clenbuterol, in healthy volunteers and patients with mild cognitive impairment or Parkinson's disease. Br J Clin Pharmacol 2024. [PMID: 38953404 DOI: 10.1111/bcp.16160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2024] [Revised: 05/30/2024] [Accepted: 06/03/2024] [Indexed: 07/04/2024] Open
Abstract
AIMS Cerebral hypometabolism occurs years prior to a diagnosis of neurodegenerative diseases and coincides with reduced cerebral perfusion and declining noradrenergic transmission from the locus coeruleus. In pre-clinical models, β-adrenoceptor (β-AR) agonists increase cerebrocortical glucose metabolism, and may have therapeutic potential for neurodegenerative diseases. This study investigated the safety and effects on regional cerebral blood flow (rCBF) of the oral, brain-penetrant β2-AR agonist, clenbuterol, in healthy volunteers (HV) and patients with mild cognitive impairment (MCI) or Parkinson's disease (PD). METHODS This study evaluated the safety and effects on cerebral activity of the oral, brain-penetrant, β2-AR agonist clenbuterol (20-160 μg) in healthy volunteers and patients with MCI or PD. Regional CBF, which is tightly coupled to glucose metabolism, was measured by arterial spin labelling MRI in 32 subjects (25 HV and 8 MCI or PD) across five cohorts. In some cohorts, low doses of nadolol (1-5 mg), a β-AR antagonist with minimal brain penetration, were administered with clenbuterol to control peripheral β2-AR responses. RESULTS Significant, dose-dependent increases in rCBF were seen in multiple brain regions, including hippocampus, amygdala and thalamus, following the administration of clenbuterol to HVs (mean changes from baseline in hippocampal rCBF of -1.7%, 7.3%, 22.9%, 28.4% 3 h after 20, 40, 80 and 160 μg clenbuterol, respectively). In patients with MCI or PD, increases in rCBF following 80 μg clenbuterol were observed both without and with 5 mg nadolol (in hippocampus, 18.6%/13.7% without/with nadolol). Clenbuterol was safe and well-tolerated in all subjects; known side effects of β2-agonists, including increased heart rate and tremor, were mild in intensity and were blocked by low-dose nadolol. CONCLUSIONS The effects of clenbuterol on rCBF were evident both in the absence and presence of low-dose nadolol, suggesting central nervous system (CNS) involvement. Concomitant inhibition of the peripheral effects of clenbuterol by nadolol confirms that meaningful β2-AR antagonism in the periphery was achieved without interrupting the central effects of clenbuterol on rCBF.
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Affiliation(s)
- Thomas Lodeweyckx
- Center for Clinical Pharmacology, Department of Pharmaceutical and Pharmacological Sciences, Catholic University Leuven, Leuven, Belgium
| | - Jan de Hoon
- Center for Clinical Pharmacology, Department of Pharmaceutical and Pharmacological Sciences, Catholic University Leuven, Leuven, Belgium
| | - Koen Van Laere
- Division of Nuclear Medicine, University Hospital Leuven and Nuclear Medicine and Molecular Imaging, KU Leuven, Leuven, Belgium
| | | | | | | | - Eugenii Rabiner
- Invicro, London, UK
- Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - Anthony Ford
- CuraSen Therapeutics, San Carlos, California, USA
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Mingels C, Weissenrieder L, Zeimpekis K, Sari H, Nardo L, Caobelli F, Alberts I, Rominger A, Pyka T. FDG imaging with long-axial field-of-view PET/CT in patients with high blood glucose-a matched pair analysis. Eur J Nucl Med Mol Imaging 2024; 51:2036-2046. [PMID: 38383743 PMCID: PMC11139721 DOI: 10.1007/s00259-024-06646-5] [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: 12/19/2023] [Accepted: 02/05/2024] [Indexed: 02/23/2024]
Abstract
PURPOSE High blood glucose (hBG) in patients undergoing [18F]FDG PET/CT scans often results in rescheduling the examination, which may lead to clinical delay for the patient and decrease productivity for the department. The aim of this study was to evaluate whether long-axial field-of-view (LAFOV) PET/CT can minimize the effect of altered bio-distribution in hBG patients and is able to provide diagnostic image quality in hBG situations. MATERIALS AND METHODS Oncologic patients with elevated blood glucose (≥ 8.0 mmol/l) and normal blood glucose (< 8.0 mmol/l, nBG) levels were matched for tumor entity, gender, age, and BMI. hBG patients were further subdivided into two groups (BG 8-11 mmol/l and BG > 11 mmol/l). Tracer uptake in the liver, muscle, and tumor was evaluated. Furthermore, image quality was compared between long acquisitions (ultra-high sensitivity mode, 360 s) on a LAFOV PET/CT and routine acquisitions equivalent to a short-axial field-of-view scanner (simulated (sSAFOV), obtained with high sensitivity mode, 120 s). Tumor-to-background ratio (TBR) and contrast-to-noise ratio (CNR) were used as the main image quality criteria. RESULTS Thirty-one hBG patients met the inclusion criteria and were matched with 31 nBG patients. Overall, liver uptake was significantly higher in hBG patients (SUVmean, 3.07 ± 0.41 vs. 2.37 ± 0.33; p = 0.03), and brain uptake was significantly lower (SUVmax, 7.58 ± 0.74 vs. 13.38 ± 3.94; p < 0.001), whereas muscle (shoulder/gluteal) uptake showed no statistically significant difference. Tumor uptake was lower in hBG patients, resulting in a significantly lower TBR in the hBG cohort (3.48 ± 0.74 vs. 5.29 ± 1.48, p < 0.001). CNR was higher in nBG compared to hBG patients (12.17 ± 4.86 vs. 23.31 ± 12.22, p < 0.001). However, subgroup analysis of nBG 8-11 mmol/l on sSAFOV PET/CT compared to hBG (> 11 mmol/l) patients examined with LAFOV PET/CT showed no statistical significant difference in CNR (19.84 ± 8.40 vs. 17.79 ± 9.3, p = 0.08). CONCLUSION While elevated blood glucose (> 11 mmol) negatively affected TBR and CNR in our cohort, the images from a LAFOV PET-scanner had comparable CNR to PET-images acquired from nBG patients using sSAFOV PET/CT. Therefore, we argue that oncologic patients with increased blood sugar levels might be imaged safely with LAFOV PET/CT when rescheduling is not feasible.
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Affiliation(s)
- Clemens Mingels
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland.
| | - Luis Weissenrieder
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Konstantinos Zeimpekis
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Hasan Sari
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
- Advanced Clinical Imaging Technology, Siemens Healthcare AG, Lausanne, Switzerland
| | - Lorenzo Nardo
- Department of Radiology, University of California Davis, Sacramento, CA, USA
| | - Federico Caobelli
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Ian Alberts
- Molecular Imaging and Therapy, BC Cancer Agency, Vancouver, BC, Canada
| | - Axel Rominger
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
| | - Thomas Pyka
- Department of Nuclear Medicine, Inselspital, University Hospital Bern, University of Bern, Freiburgstr. 18, 3010, Bern, Switzerland
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Lee H, Hwang KH. Focal incidental colorectal fluorodeoxyglucose uptake: Should it be spotlighted? World J Clin Cases 2024; 12:2466-2474. [PMID: 38817235 PMCID: PMC11135452 DOI: 10.12998/wjcc.v12.i15.2466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/17/2024] [Accepted: 04/12/2024] [Indexed: 05/14/2024] Open
Abstract
Fluorine-18 fluorodeoxyglucose (F-18 FDG) positron emission tomography/computed tomography (PET/CT) has emerged as a cornerstone in cancer evaluation imaging, with a well-established history spanning several years. This imaging modality, encompassing the examination of the body from the base of the skull to the upper thighs, comprehensively covers the chest and abdominopelvic regions in a singular scan, allowing for a holistic assessment of nearly the entire body, including areas of marginal interest. The inherent advantage of this expansive scan range lies in its potential to unveil unexpected incidental abnormal hypermetabolic areas. The identification of incidental focal FDG uptake within colorectal regions during PET/CT scans is not an uncommon occurrence, albeit fraught with challenges associated with non-specific FDG uptake. The presence of benign colorectal lesions or physiological uptake poses a particular obstacle, as these may manifest with FDG uptake levels that mimic malignancy. Consequently, physicians are confronted with a diagnostic dilemma when encountering abnormal FDG uptake in unexpected colorectal areas. Existing studies have presented divergent results concerning these uptakes. Standardized uptake value and its derivatives have served as pivotal metrics in quantifying FDG uptake in PET images. In this article, we aim to succinctly explore the distinctive characteristics of FDG, delve into imaging findings, and elucidate the clinical significance of incidental focal colorectal uptake. This discussion aims to contribute valuable insights into the nuanced interpretation of such findings, fostering a comprehensive understanding.
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Affiliation(s)
- Haejun Lee
- Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
| | - Kyung-Hoon Hwang
- Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
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Lee H, Hwang KH. Unexpected focal fluorodeoxyglucose uptake in main organs; pass through or pass by? World J Clin Cases 2024; 12:1885-1899. [PMID: 38660550 PMCID: PMC11036514 DOI: 10.12998/wjcc.v12.i11.1885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Revised: 01/31/2024] [Accepted: 03/21/2024] [Indexed: 04/11/2024] Open
Abstract
Since the inception of fluorine-18 fluorodeoxyglucose (F-18 FDG), positron emission tomography/computed tomography (PET/CT) utilizing F-18 FDG has become widely accepted as a valuable imaging modality in the field of oncology, with global prevalence in clinical practice. Given that a single Torso PET/CT scan encompasses the anatomical region from the skull base to the upper thigh, the detection of incidental abnormal focal hypermetabolism in areas of limited clinical interest is both feasible and not uncommon. Numerous investigations have been undertaken to delineate the distinctive features of these findings, yet the outcomes have proven inconclusive. The incongruent results of these studies present a challenge for physicians, leaving them uncertain about the appropriate course of action. This article provides a succinct overview of the characteristics of fluorodeoxyglucose, followed by a comprehensive discussion of the imaging findings and clinical significance associated with incidental focal abnormal F-18 FDG activity in several representative organs. In conclusion, while the prevalence of unrecognized malignancy varies across organs, malignancies account for a substantial proportion, ranging from approximately one-third to over half, of incidental focal uptake. In light of these rates, physicians are urged to exercise vigilance in not disregarding unexpected uptake, facilitating more assured clinical decisions, and advocating for further active evaluation.
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Affiliation(s)
- Haejun Lee
- Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
| | - Kyung-Hoon Hwang
- Department of Nuclear Medicine, Gachon University College of Medicine, Gil Medical Center, Incheon 21565, South Korea
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Moreira GS, Feijóo NDAP, Tinoco-da-Silva IB, Aguiar CM, da Conceição FO, de Castro GCM, de Carvalho MGB, de Almeida TVDPA, Garrido RQ, Lamas CDC. Splenic Embolism in Infective Endocarditis: A Systematic Review of the Literature with an Emphasis on Radiological and Histopathological Diagnoses. Trop Med Infect Dis 2024; 9:83. [PMID: 38668544 PMCID: PMC11053958 DOI: 10.3390/tropicalmed9040083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 04/08/2024] [Accepted: 04/10/2024] [Indexed: 04/29/2024] Open
Abstract
Infective endocarditis (IE) is characterised by fever, heart murmurs, and emboli. Splenic emboli are frequent in left-sided IE. A systematic review of the literature published on splenic embolism (SE) between 2000 and 2023 was conducted. Search strategies in electronic databases identified 2751 studies published between 1 January 2000 and 4 October 2023, of which 29 were finally included. The results showed that the imaging tests predominantly used to detect embolisms were computed tomography (CT), magnetic resonance imaging, positron emission tomography (PET)/CT, single-photon emission computed tomography/CT, ultrasound, and contrast-enhanced ultrasound. More recent studies typically used 18F-FDG PET-CT. The proportion of SE ranged from 1.4% to 71.7%. Only seven studies performed systematic conventional CT screening for intra-abdominal emboli, and the weighted mean frequency of SE was 22% (range: 8-34.8%). 18F-FDG PET-CT was performed systematically in seven studies, and splenic uptake was found in a weighted mean of 4.5%. There was a lack of uniformity in the published literature regarding the frequency and management of splenic embolisation. CT scans were the most frequently used method, until recently, when 18F-FDG PET-CT scans began to predominate. More data are necessary regarding the frequency of SE, especially focusing on their impact on IE management and prognosis.
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Affiliation(s)
- Gabriel Santiago Moreira
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
| | - Nícolas de Albuquerque Pereira Feijóo
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
| | - Isabella Braga Tinoco-da-Silva
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
| | - Cyntia Mendes Aguiar
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
| | | | - Gustavo Campos Monteiro de Castro
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
| | - Mariana Giorgi Barroso de Carvalho
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
| | - Thatyane Veloso de Paula Amaral de Almeida
- Department of Medicine, Universidade do Grande Rio/Afya (UNIGRANRIO/Afya), Barra da Tijuca, Rio de Janeiro 22775-003, Rio de Janeiro, Brazil; (G.S.M.); (N.d.A.P.F.)
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
| | - Rafael Quaresma Garrido
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
- Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21040-360, Rio de Janeiro, Brazil
| | - Cristiane da Cruz Lamas
- Instituto Nacional de Cardiologia, Rio de Janeiro 22240-006, Rio de Janeiro, Brazil; (C.M.A.); (F.O.d.C.); (R.Q.G.)
- Instituto Nacional de Infectologia Evandro Chagas, Fiocruz, Rio de Janeiro 21040-360, Rio de Janeiro, Brazil
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Spelta LEW, Real CC, Bruno V, Buchpiguel CA, Garcia RCT, Torres LH, de Paula Faria D, Marcourakis T. Impact of cannabidiol on brain glucose metabolism of C57Bl/6 male mice previously exposed to cocaine. J Neurosci Res 2024; 102:e25327. [PMID: 38588037 DOI: 10.1002/jnr.25327] [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: 11/27/2023] [Revised: 03/04/2024] [Accepted: 03/24/2024] [Indexed: 04/10/2024]
Abstract
Despite evidence of the beneficial effects of cannabidiol (CBD) in animal models of cocaine use disorder (CUD), CBD neuronal mechanisms remain poorly understood. This study investigated the effects of CBD treatment on brain glucose metabolism, in a CUD animal model, using [18F]FDG positron emission tomography (PET). Male C57Bl/6 mice were injected with cocaine (20 mg/kg, i.p.) every other day for 9 days, followed by 8 days of CBD administration (30 mg/kg, i.p.). After 48 h, animals were challenged with cocaine. Control animals received saline/vehicle. [18F]FDG PET was performed at four time points: baseline, last day of sensitization, last day of withdrawal/CBD treatment, and challenge. Subsequently, the animals were euthanized and immunohistochemistry was performed on the hippocampus and amygdala to assess the CB1 receptors, neuronal nuclear protein, microglia (Iba1), and astrocytes (GFAP). Results showed that cocaine administration increased [18F]FDG uptake following sensitization. CBD treatment also increased [18F]FDG uptake in both saline and cocaine groups. However, animals that were sensitized and challenged with cocaine, and those receiving only an acute cocaine injection during the challenge phase, did not exhibit increased [18F]FDG uptake when treated with CBD. Furthermore, CBD induced modifications in the integrated density of NeuN, Iba, GFAP, and CB1R in the hippocampus and amygdala. This is the first study addressing the impact of CBD on brain glucose metabolism in a preclinical model of CUD using PET. Our findings suggest that CBD disrupts cocaine-induced changes in brain energy consumption and activity, which might be correlated with alterations in neuronal and glial function.
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Affiliation(s)
- Lidia Emmanuela Wiazowski Spelta
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Caroline Cristiano Real
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
- Department of Clinical Medicine, Nuclear Medicine and PET Centre, Aarhus University, Aarhus, Denmark
| | - Vitor Bruno
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | | | - Larissa Helena Torres
- Department of Food and Drugs, School of Pharmaceutical Sciences, Federal University of Alfenas, Alfenas, Brazil
| | - Daniele de Paula Faria
- Laboratory of Nuclear Medicine, Department of Radiology and Oncology, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Tania Marcourakis
- Laboratory of Neurotoxicology, Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of São Paulo, São Paulo, Brazil
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Hao L, Wang L, Ju M, Feng W, Guo Z, Sun X, Xiao R. 27-Hydroxycholesterol impairs learning and memory ability via decreasing brain glucose uptake mediated by the gut microbiota. Biomed Pharmacother 2023; 168:115649. [PMID: 37806088 DOI: 10.1016/j.biopha.2023.115649] [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] [Received: 06/06/2023] [Revised: 09/25/2023] [Accepted: 10/03/2023] [Indexed: 10/10/2023] Open
Abstract
Brain glucose hypometabolism is a significant manifestation of Alzheimer's disease (AD). 27-hydroxycholesterol (27-OHC) and the gut microbiota have been recognized as factors possibly influencing the pathogenesis of AD. This study aimed to investigate the link between 27-OHC, the gut microbiota, and brain glucose uptake in AD. Here, 6-month-old male C57BL/6 J mice were treated with sterile water or antibiotic cocktails, with or without 27-OHC and/or 27-OHC synthetic enzyme CYP27A1 inhibitor anastrozole (ANS). The gut microbiota, brain glucose uptake levels, and memory ability were measured. We observed that 27-OHC altered microbiota composition, damaged brain tissue structures, decreased the 2-deoxy-2-[18 F] fluorodeoxyglucose (18F-FDG) uptake value, downregulated the gene expression of glucose transporter type 4 (GLUT4), reduced the colocalization of GLUT1/glial fibrillary acidic protein (GFAP) in the hippocampus, and impaired spatial memory. ANS reversed the effects of 27-OHC. The antibiotic-treated mice did not exhibit similar results after 27-OHC treatment. This study reveals a potential molecular mechanism wherein 27-OHC-induced memory impairment might be linked to reduced brain glucose uptake, mediated by the gut microbiota.
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Affiliation(s)
- Ling Hao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Lijing Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Mengwei Ju
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Wenjing Feng
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Zhiting Guo
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Xuejing Sun
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China
| | - Rong Xiao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing 100069, China.
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Chouliaras L, O'Brien JT. The use of neuroimaging techniques in the early and differential diagnosis of dementia. Mol Psychiatry 2023; 28:4084-4097. [PMID: 37608222 PMCID: PMC10827668 DOI: 10.1038/s41380-023-02215-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 07/27/2023] [Accepted: 08/03/2023] [Indexed: 08/24/2023]
Abstract
Dementia is a leading cause of disability and death worldwide. At present there is no disease modifying treatment for any of the most common types of dementia such as Alzheimer's disease (AD), Vascular dementia, Lewy Body Dementia (LBD) and Frontotemporal dementia (FTD). Early and accurate diagnosis of dementia subtype is critical to improving clinical care and developing better treatments. Structural and molecular imaging has contributed to a better understanding of the pathophysiology of neurodegenerative dementias and is increasingly being adopted into clinical practice for early and accurate diagnosis. In this review we summarise the contribution imaging has made with particular focus on multimodal magnetic resonance imaging (MRI) and positron emission tomography imaging (PET). Structural MRI is widely used in clinical practice and can help exclude reversible causes of memory problems but has relatively low sensitivity for the early and differential diagnosis of dementia subtypes. 18F-fluorodeoxyglucose PET has high sensitivity and specificity for AD and FTD, while PET with ligands for amyloid and tau can improve the differential diagnosis of AD and non-AD dementias, including recognition at prodromal stages. Dopaminergic imaging can assist with the diagnosis of LBD. The lack of a validated tracer for α-synuclein or TAR DNA-binding protein 43 (TDP-43) imaging remain notable gaps, though work is ongoing. Emerging PET tracers such as 11C-UCB-J for synaptic imaging may be sensitive early markers but overall larger longitudinal multi-centre cross diagnostic imaging studies are needed.
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Affiliation(s)
- Leonidas Chouliaras
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK
- Specialist Dementia and Frailty Service, Essex Partnership University NHS Foundation Trust, St Margaret's Hospital, Epping, UK
| | - John T O'Brien
- Department of Psychiatry, University of Cambridge School of Clinical Medicine, Cambridge, UK.
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
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Choi YS, Song JE, Kim E, Kim CH, Lee JE, Song HT. Hyperpolarized [1- 13C]pyruvate Magnetic Resonance Spectroscopy Shows That Agmatine Increased Lactate Production in the Brain of Type 2 Diabetic Mice. Yonsei Med J 2023; 64:625-632. [PMID: 37727922 PMCID: PMC10522877 DOI: 10.3349/ymj.2022.0554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 07/19/2023] [Accepted: 07/27/2023] [Indexed: 09/21/2023] Open
Abstract
PURPOSE Type 2 diabetes mellitus (T2DM) is associated with a 2-fold increased risk of developing Alzheimer's disease. In earlier research, agmatine has been demonstrated to alleviate diabetes symptoms and increase cognitive performance. However, it is unclear whether the improvement of cognitive function is attributable to the reduction of diabetic symptoms or its direct influence on brain metabolism. Using hyperpolarized (HP) [1-13C]pyruvate magnetic resonance spectroscopy (MRS), this study intends to evaluate the influence of agmatine on brain metabolism. MATERIALS AND METHODS ICR mice were fed a high-fat diet and injected with streptozotocin to develop a T2DM animal model. During a 2-week period, T2DM mice were treated with normal saline or 100 mg/kg of agmatine, and brain HP [1-13C]pyruvate MRS was performed. The effect of agmatine on lactate generation and NADH/NAD+ redox state was investigated using C6 and neuro-2a (N2a) cells. RESULTS As a perfusion marker, the total 13C signals in the brain of T2DM mice (p=0.07) and agmatine-treated mice (p<0.05) were reduced. The conversion constant (Kpl) from [1-13C]pyruvate to [1-13C]lactate was not distinguishable in the brains of T2DM mice but was significantly increased in the brains of agmatine-treated T2DM mice. Treating C6 and N2a cells with agmatine increased NADH/NAD+ratio and lactate generation. CONCLUSION Agmatine influences the NADH/NAD+ redox state in the brains of T2DM mice, which may be connected with enhanced cognitive performance and increased conversion of HP [1-13C]pyruvate to HP [1-13C]lactate.
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Affiliation(s)
- Young-Suk Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea
| | - Jae Eun Song
- Department of Radiology, Stanford University, Palo Alto, CA, USA
- Promaxo Inc., Oakland, CA, USA
| | - Eosu Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Chul Hoon Kim
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, Korea
- BK21 PLUS Project for Medical Sciences and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Eun Lee
- BK21 PLUS Project for Medical Sciences and Brain Research Institute, Yonsei University College of Medicine, Seoul, Korea
- Department of Anatomy and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
| | - Ho-Taek Song
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Korea.
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10
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Zhang P, Chen W, Zhao K, Qiu X, Li T, Zhu X, Sun P, Wang C, Song Y. Tumor to liver maximum standardized uptake value ratio of FDG-PET/CT parameters predicts tumor treatment response and survival of stage III non-small cell lung cancer. BMC Med Imaging 2023; 23:107. [PMID: 37582701 PMCID: PMC10428530 DOI: 10.1186/s12880-023-01067-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 07/28/2023] [Indexed: 08/17/2023] Open
Abstract
BACKGROUND To assess the predictive values of primary tumor FDG uptake for patients with inoperable stage III non-small cell lung cancer (NSCLC) after concurrent chemoradiotherapy (CCRT). METHODS A total of 107 patients with diagnosis of stage III NSCLC and CCRT were enrolled. The tumor maximum uptake value (SUVmax) was standardized by calculating several ratios between tumor and each background tissues. The receiver operating characteristics curve (ROC) was used to compare the predictive power of prognostic models. The tumor objective response rate (ORR) and overall survival (OS) were compared and analyzed by the Kaplan-Meier method and univariate and multivariate Cox regression models. RESULTS The areas under ROC curve (AUCs) ranged from 0.72 to 0.81 among these tumor SUVmax and standardized SUVmax ratios, and the tumor SUVmax and tumor SUVmax-to-liver SUVmean ratio (TLMR) were more predictive of ORR (AUC, 0.81; 95% CI, 0.73-0.88 for tumor SUVmax and AUC, 0.84; 95%CI, 0.76-0.91 for TLMR) than any of other SUVmax ratios. The patients with lower tumor SUVmax, SUVmean and SUVmax ratios had a significantly better OS than those with their corresponding higher ones. Moreover, both univariate and multivariable analyses revealed that TLMR was significantly associated with better ORR and OS after adjustment with other prognostic variables. CONCLUSIONS TLMR, a standardized tumor SUVmax, was an independent prognostic predictor for tumor ORR and OS of patients with stage III NSCLC after CCRT.
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Affiliation(s)
- Pengfei Zhang
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Wei Chen
- Department of Training Education, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Kewei Zhao
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaowen Qiu
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Tao Li
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Xingzhuang Zhu
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China
| | - Peng Sun
- Department of Otolaryngology, The First Affiliated Hospital of Soochow University, Suzhou, 215006, China
| | - Chunsheng Wang
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China.
- Department of Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University, Wuhan, 430071, Hubei, People's Republic of China.
| | - Yipeng Song
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, 264000, Shandong, China.
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11
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Lu W, Duan Y, Li K, Qiu J, Cheng Z. Glucose uptake and distribution across the human skeleton using state-of-the-art total-body PET/CT. Bone Res 2023; 11:36. [PMID: 37407553 DOI: 10.1038/s41413-023-00268-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/25/2023] [Accepted: 05/12/2023] [Indexed: 07/07/2023] Open
Abstract
A growing number of studies have demonstrated that the skeleton is an endocrine organ that is involved in glucose metabolism and plays a significant role in human glucose homeostasis. However, there is still a limited understanding of the in vivo glucose uptake and distribution across the human skeleton. To address this issue, we aimed to elucidate the detailed profile of glucose uptake across the skeleton using a total-body positron emission tomography (PET) scanner. A total of 41 healthy participants were recruited. Two of them received a 1-hour dynamic total-body 18F-fluorodeoxyglucose (18F-FDG) PET scan, and all of them received a 10-minute static total-body 18F-FDG PET scan. The net influx rate (Ki) and standardized uptake value normalized by lean body mass (SUL) were calculated as indicators of glucose uptake from the dynamic and static PET data, respectively. The results showed that the vertebrae, hip bone and skull had relatively high Ki and SUL values compared with metabolic organs such as the liver. Both the Ki and SUL were higher in the epiphyseal, metaphyseal and cortical regions of long bones. Moreover, trends associated with age and overweight with glucose uptake (SULmax and SULmean) in bones were uncovered. Overall, these results indicate that the skeleton is a site with significant glucose uptake, and skeletal glucose uptake can be affected by age and dysregulated metabolism.
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Affiliation(s)
- Weizhao Lu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China
| | - Yanhua Duan
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated with Shandong University, Jinan, 250014, China
| | - Kun Li
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated with Shandong University, Jinan, 250014, China
| | - Jianfeng Qiu
- Department of Radiology, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, 271016, China.
| | - Zhaoping Cheng
- Department of PET-CT, the First Affiliated Hospital of Shandong First Medical University, Shandong Provincial Qianfoshan Hospital Affiliated with Shandong University, Jinan, 250014, China.
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12
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Pijl JP, Glaudemans AWJM, Gheysens O, Slart RHJA, Kwee TC. Importance of Blood Glucose Management Before 18F-FDG PET/CT in 322 Patients with Bacteremia of Unknown Origin. J Nucl Med 2023:jnumed.122.264839. [PMID: 37414447 DOI: 10.2967/jnumed.122.264839] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Revised: 04/14/2023] [Indexed: 07/08/2023] Open
Abstract
We investigated the effects of blood glucose levels on the performance of 18F-FDG PET/CT for detecting an infection focus in patients with bacteremia. Methods: A total of 322 consecutive patients with bacteremia who underwent 18F-FDG PET/CT between 2010 and 2021 were included. Logistic regression analysis was performed to evaluate the association between finding a true-positive infection focus on 18F-FDG PET/CT and blood glucose level, type of diabetes, and use of hypoglycemic medication. C-reactive protein, leukocyte count, duration of antibiotic treatment, and type of isolated bacteria were considered as well. Results: Blood glucose level (odds ratio, 0.76 per unit increase; P = <0.001) was significantly and independently associated with 18F-FDG PET/CT outcome. In patients with a blood glucose level between 3.0 and 7.9 mmol/L (54-142 mg/dL), the true-positive detection rate of 18F-FDG PET/CT varied between 61% and 65%, whereas in patients with a blood glucose level between 8.0 and 10.9 mmol/L (144-196 mg/dL), the true-positive detection rate decreased to 30%-38%. In patients with a blood glucose level greater than 11.0 mmol/L (200 mg/dL), the true-positive detection rate was 17%. In addition to C-reactive protein (odds ratio, 1.004 per point increase; P = 0.009), no other variables were independently associated with 18F-FDG PET/CT outcome. Conclusion: In patients with moderate to severe hyperglycemia, 18F-FDG PET/CT was much less likely to identify the focus of infection than in normoglycemic patients. Although current guidelines recommend postponing 18F-FDG PET/CT only in cases of severe hyperglycemia with glucose levels greater than 11 mmol/L (200 mg/dL), a lower blood glucose threshold seems to be more appropriate in patients with bacteremia of unknown origin and other infectious diseases.
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Affiliation(s)
- Jordy P Pijl
- Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands;
| | - Andor W J M Glaudemans
- Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Olivier Gheysens
- Department of Nuclear Medicine, Cliniques Universitaires Saint-Luc and Institute of Clinical and Experimental Research, Université Catholique de Louvain, Brussels, Belgium; and
| | - Riemer H J A Slart
- Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
- Department of Biomedical Photonic Imaging, University of Twente, Enschede, The Netherlands
| | - Thomas C Kwee
- Medical Imaging Center, Department of Radiology, Nuclear Medicine and Molecular Imaging, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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13
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Al-Ibraheem A, Abdlkadir AS, Juweid ME, Al-Rabi K, Ma’koseh M, Abdel-Razeq H, Mansour A. FDG-PET/CT in the Monitoring of Lymphoma Immunotherapy Response: Current Status and Future Prospects. Cancers (Basel) 2023; 15:1063. [PMID: 36831405 PMCID: PMC9954669 DOI: 10.3390/cancers15041063] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Revised: 01/24/2023] [Accepted: 02/03/2023] [Indexed: 02/10/2023] Open
Abstract
Cancer immunotherapy has been extensively investigated in lymphoma over the last three decades. This new treatment modality is now established as a way to manage and maintain several stages and subtypes of lymphoma. The establishment of this novel therapy has necessitated the development of new imaging response criteria to evaluate and follow up with cancer patients. Several FDG PET/CT-based response criteria have emerged to address and encompass the various most commonly observed response patterns. Many of the proposed response criteria are currently being used to evaluate and predict responses. The purpose of this review is to address the efficacy and side effects of cancer immunotherapy and to correlate this with the proposed criteria and relevant patterns of FDG PET/CT in lymphoma immunotherapy as applicable. The latest updates and future prospects in lymphoma immunotherapy, as well as PET/CT potentials, will be discussed.
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Affiliation(s)
- Akram Al-Ibraheem
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center, Al-Jubeiha, Amman 11941, Jordan
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Amman 11942, Jordan
| | - Ahmed Saad Abdlkadir
- Department of Nuclear Medicine and PET/CT, King Hussein Cancer Center, Al-Jubeiha, Amman 11941, Jordan
| | - Malik E. Juweid
- Department of Radiology and Nuclear Medicine, Division of Nuclear Medicine, University of Jordan, Amman 11942, Jordan
| | - Kamal Al-Rabi
- Department of Medical Oncology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Mohammad Ma’koseh
- Department of Medical Oncology, King Hussein Cancer Center, Amman 11941, Jordan
| | - Hikmat Abdel-Razeq
- Department of Internal Medicine, King Hussein Cancer Center, Amman 11941, Jordan
- Department of Internal Medicine, School of Medicine, University of Jordan, Amman 11942, Jordan
| | - Asem Mansour
- Department of Diagnostic Radiology, King Hussein Cancer Center, Amman 11941, Jordan
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14
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Zwezerijnen GJC, Eertink JJ, Ferrández MC, Wiegers SE, Burggraaff CN, Lugtenburg PJ, Heymans MW, de Vet HCW, Zijlstra JM, Boellaard R. Reproducibility of [18F]FDG PET/CT liver SUV as reference or normalisation factor. Eur J Nucl Med Mol Imaging 2023; 50:486-493. [PMID: 36166080 PMCID: PMC9816285 DOI: 10.1007/s00259-022-05977-5] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2022] [Accepted: 09/15/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Although visual and quantitative assessments of [18F]FDG PET/CT studies typically rely on liver uptake value as a reference or normalisation factor, consensus or consistency in measuring [18F]FDG uptake is lacking. Therefore, we evaluate the variation of several liver standardised uptake value (SUV) measurements in lymphoma [18F]FDG PET/CT studies using different uptake metrics. METHODS PET/CT scans from 34 lymphoma patients were used to calculate SUVmaxliver, SUVpeakliver and SUVmeanliver as a function of (1) volume-of-interest (VOI) size, (2) location, (3) imaging time point and (4) as a function of total metabolic tumour volume (MTV). The impact of reconstruction protocol on liver uptake is studied on 15 baseline lymphoma patient scans. The effect of noise on liver SUV was assessed using full and 25% count images of 15 lymphoma scans. RESULTS Generally, SUVmaxliver and SUVpeakliver were 38% and 16% higher compared to SUVmeanliver. SUVmaxliver and SUVpeakliver increased up to 31% and 15% with VOI size while SUVmeanliver remained unchanged with the lowest variability for the largest VOI size. Liver uptake metrics were not affected by VOI location. Compared to baseline, liver uptake metrics were 15-18% and 9-18% higher at interim and EoT PET, respectively. SUVliver decreased with larger total MTVs. SUVmaxliver and SUVpeakliver were affected by reconstruction protocol up to 62%. SUVmax and SUVpeak moved 22% and 11% upward between full and 25% count images. CONCLUSION SUVmeanliver was most robust against VOI size, location, reconstruction protocol and image noise level, and is thus the most reproducible metric for liver uptake. The commonly recommended 3 cm diameter spherical VOI-based SUVmeanliver values were only slightly more variable than those seen with larger VOI sizes and are sufficient for SUVmeanliver measurements in future studies. TRIAL REGISTRATION EudraCT: 2006-005,174-42, 01-08-2008.
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Affiliation(s)
- Gerben J C Zwezerijnen
- Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Jakoba J Eertink
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Hematology, Amsterdam, The Netherlands
| | - Maria C Ferrández
- Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Sanne E Wiegers
- Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
| | - Coreline N Burggraaff
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Hematology, Amsterdam, The Netherlands
| | | | - Martijn W Heymans
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, The Netherlands
| | - Henrica C W de Vet
- Epidemiology and Data Science, Amsterdam UMC Location Vrije Universiteit Amsterdam, De Boelelaan 1117, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, The Netherlands
| | - Josée M Zijlstra
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands
- Amsterdam UMC Location Vrije Universiteit Amsterdam, Hematology, Amsterdam, The Netherlands
| | - Ronald Boellaard
- Radiology and Nuclear Medicine, Amsterdam UMC Location Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Cancer Center Amsterdam, Imaging and Biomarkers, Amsterdam, The Netherlands.
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15
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Application of Metabolic Reprogramming to Cancer Imaging and Diagnosis. Int J Mol Sci 2022; 23:ijms232415831. [PMID: 36555470 PMCID: PMC9782057 DOI: 10.3390/ijms232415831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/23/2022] Open
Abstract
Cellular metabolism governs the signaling that supports physiological mechanisms and homeostasis in an individual, including neuronal transmission, wound healing, and circadian clock manipulation. Various factors have been linked to abnormal metabolic reprogramming, including gene mutations, epigenetic modifications, altered protein epitopes, and their involvement in the development of disease, including cancer. The presence of multiple distinct hallmarks and the resulting cellular reprogramming process have gradually revealed that these metabolism-related molecules may be able to be used to track or prevent the progression of cancer. Consequently, translational medicines have been developed using metabolic substrates, precursors, and other products depending on their biochemical mechanism of action. It is important to note that these metabolic analogs can also be used for imaging and therapeutic purposes in addition to competing for metabolic functions. In particular, due to their isotopic labeling, these compounds may also be used to localize and visualize tumor cells after uptake. In this review, the current development status, applicability, and limitations of compounds targeting metabolic reprogramming are described, as well as the imaging platforms that are most suitable for each compound and the types of cancer to which they are most appropriate.
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16
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Geiger KR, Pasvolsky O, Berger T, Raanani P, Shochat T, Gurion R, Anati T, Groshar D, Gafter-Gvili A, Bernstine H. Effect of steroid treatment on the diagnostic yield of baseline 18f-fluorodeoxyglucose positron emission tomography in aggressive B cell lymphoma. EJNMMI Res 2022; 12:59. [PMID: 36104603 PMCID: PMC9474759 DOI: 10.1186/s13550-022-00924-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 08/17/2022] [Indexed: 01/18/2023] Open
Abstract
Aggressive B cell lymphoma often requires prompt steroid treatment, even before baseline 18f-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) and definitive treatment, to alleviate symptoms or prevent organ damage. Since lymphoma is a steroid-sensitive malignancy, there are concerns that steroids might affect the results of FDG PET/CT and decrease its diagnostic yield. The aim of the current study was to evaluate the effect of steroids administered before baseline PET/CT on the maximum standardized uptake value (SUVmax) and additional PET/CT parameters. Retrospective review of the database in a tertiary medical center yielded 178 patients newly diagnosed with aggressive B cell lymphoma between January 2017 and May 2020 who had an available baseline FDG PET/CT scan. The cohort was divided into patients who received steroids before PET/CT (n = 47) and those who did not (n = 131), and the groups were compared for SUVmax and additional PET/CT parameters. The steroid-treated group had a higher disease stage and lactate dehydrogenase level compared to the steroid-naïve group, with a trend toward a higher international prognostic index. There was no significant between-group difference in SUVmax (P = 0.61). This finding remained consistent across steroid treatment durations and dosage regimens. Further evaluation revealed a significantly larger mean tumor volume and a trend toward a higher tumor metabolic burden in the steroid-treated group, yet no between-group difference in SUV mean or other PET/CT parameters. In this retrospective analysis of patients with aggressive B cell lymphoma, steroid prophase prior to baseline PET/CT did not decrease the diagnostic yield of the scan. However, further studies are required to fully appreciate the impact of steroids on PET CT parameters.
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17
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Abstract
The consumption of fructose as sugar and high-fructose corn syrup has markedly increased during the past several decades. This trend coincides with the exponential rise of metabolic diseases, including obesity, nonalcoholic fatty liver disease, cardiovascular disease, and diabetes. While the biochemical pathways of fructose metabolism were elucidated in the early 1990s, organismal-level fructose metabolism and its whole-body pathophysiological impacts have been only recently investigated. In this review, we discuss the history of fructose consumption, biochemical and molecular pathways involved in fructose metabolism in different organs and gut microbiota, the role of fructose in the pathogenesis of metabolic diseases, and the remaining questions to treat such diseases.
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Affiliation(s)
- Sunhee Jung
- Department of Biological Chemistry, University of California, Irvine, California, USA
| | - Hosung Bae
- Department of Biological Chemistry, University of California, Irvine, California, USA
| | - Won-Suk Song
- Department of Biological Chemistry, University of California, Irvine, California, USA;,Institute of Bioengineering, Bio-MAX, Seoul National University, Seoul, South Korea
| | - Cholsoon Jang
- Department of Biological Chemistry, University of California, Irvine, California, USA;,Chao Family Comprehensive Cancer Center, University of California, Irvine, California, USA,Center for Complex Biological Systems, University of California, Irvine, California, USA,Center for Epigenetics and Metabolism, University of California, Irvine, California, USA
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18
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Sayed MHM, Abdelnaim AKM, Mohamadien NRA. Intrapatient variability of 18F-FDG uptake in normal tissues. J Clin Imaging Sci 2022; 12:37. [PMID: 36128350 PMCID: PMC9479622 DOI: 10.25259/jcis_23_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 05/31/2022] [Indexed: 11/08/2022] Open
Abstract
Objectives To investigate the effect of serum glucose level and other confounding factors on the variability of maximum standardized uptake value (SUVmax) in normal tissues within the same patient on two separate occasions and to suggest an ideal reference tissue. Materials and Methods We retrospectively reviewed 334 18F-FDG PET/CT scans of 167 cancer patients including 38 diabetics. All patients had two studies, on average 152 ± 68 days apart. Ten matched volumes of interest were drawn on the brain, right tonsil, blood pool, heart, lung, liver, spleen, bone marrow, fat, and iliopsoas muscle opposite third lumber vertebra away from any pathological 18F-FDG uptake to calculate SUVmax. Results SUVmax of the lungs and heart were significantly different in the two studies (P = 0.003 and P = 0.024 respectively). Only the brain uptake showed a significant moderate negative correlation with the level of blood glucose in diabetic patients (r = −0.537, P = 0.001) in the first study, while the SUVmax of other tissues showed negligible or weak correlation with the level of blood glucose in both studies. The liver showed significant moderate positive correlation with body mass index (BMI) in both studies (r = .416, P = <0.001 versus r = 0.453, P = <0.001, respectively), and blood pool activity showed significant moderate positive correlation with BMI in the first study only (r = 0.414, P = <0.001). The liver and blood pool activities showed significant moderate negative correlation with 18F-FDG uptake time in first study only (r = −0.405, P-value = <0.001; and r = −0.409, P-value = <0.001, respectively). In the multivariate analysis, the liver showed a consistent effect of the injected 18F-FDG dose and uptake duration on its SUVmax on the two occasions. In comparison, spleen and muscle showed consistent effect only of the injected dose on the two occasions. Conclusion The liver, muscle, and splenic activities showed satisfactory test/retest stability and can be used as reference activities. The spleen and muscle appear to be more optimal reference than the liver, as it is only associated with the injected dose of 18F-FDG.
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Affiliation(s)
- Mohamed Hosny Mohamed Sayed
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | - Aya KM Abdelnaim
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
| | - Nsreen RA Mohamadien
- Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Assiut University, Assiut, Egypt,
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Sohn JY, Chae Y, Koo Y, Yun T, Lee D, Park J, Son M, Choi Y, Ku D, Kim H, Yang MP, Kang BT. Evaluation of 18F-fluorodeoxyglucose uptake of beagle dogs for different durations of isoflurane anesthesia. CANADIAN JOURNAL OF VETERINARY RESEARCH = REVUE CANADIENNE DE RECHERCHE VETERINAIRE 2022; 86:132-139. [PMID: 35388230 PMCID: PMC8978286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 09/06/2021] [Indexed: 06/14/2023]
Abstract
18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) is used for tumor evaluation. In veterinary medicine, anesthesia is an essential tool during the PET scanning process. However, the changes in FDG uptake in dogs that have undergone anesthesia for a longer duration have not been studied. This study aimed to analyze the influence of isoflurane anesthesia on FDG uptake in dogs undergoing PET. A crossover design was implemented by exposing 3 groups of 6 dogs to different durations of anesthesia (60, 90, and 150 minutes). Inhalation anesthesia was maintained throughout the scanning process (30 minutes) and FDG was injected 1 hour before the start of the PET scan. The standard uptake value of FDG was obtained for the 7 gross structures (whole brain, lung, salivary gland, liver, spleen, mediastinal blood pool, and kidney cortex) as well as for the 7 intracranial structures (frontal, parietal, temporal and occipital lobes, cerebellum, brain stem, and caudal colliculus). The whole brain and intracranial structures showed significantly lower FDG uptake in dogs with a longer duration of anesthesia, whereas other gross structures did not. Our results suggest that the duration of anesthesia should be considered when evaluating the uptake of FDG by the brain.
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Affiliation(s)
- Ji-Yun Sohn
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Yeon Chae
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Yoonhoi Koo
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Taesik Yun
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Dohee Lee
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Jooyoung Park
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Mingyun Son
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Yujin Choi
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Dayoung Ku
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Hakhyun Kim
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Mhan-Pyo Yang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
| | - Byeong-Teck Kang
- Laboratory of Veterinary Internal Medicine, College of Veterinary Medicine, Chungbuk National University, Cheongju, Chungbuk 28644, South Korea
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Methodological exploration on the construction of a traditional Chinese medicine nursing expert consensus based on evidence—taking stroke as an example. JOURNAL OF TRADITIONAL CHINESE MEDICAL SCIENCES 2022. [DOI: 10.1016/j.jtcms.2022.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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21
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de Paula Faria D, Estessi de Souza L, Duran FLDS, Buchpiguel CA, Britto LR, Crippa JADS, Filho GB, Real CC. Cannabidiol Treatment Improves Glucose Metabolism and Memory in Streptozotocin-Induced Alzheimer’s Disease Rat Model: A Proof-of-Concept Study. Int J Mol Sci 2022; 23:ijms23031076. [PMID: 35163003 PMCID: PMC8835532 DOI: 10.3390/ijms23031076] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/13/2022] [Accepted: 01/16/2022] [Indexed: 12/27/2022] Open
Abstract
An early and persistent sign of Alzheimer’s disease (AD) is glucose hypometabolism, which can be evaluated by positron emission tomography (PET) with 18F-2-fluoro-2-deoxy-D-glucose ([18F]FDG). Cannabidiol has demonstrated neuroprotective and anti-inflammatory properties but has not been evaluated by PET imaging in an AD model. Intracerebroventricular (icv) injection of streptozotocin (STZ) is a validated model for hypometabolism observed in AD. This proof-of-concept study evaluated the effect of cannabidiol treatment in the brain glucose metabolism of an icv-STZ AD model by PET imaging. Wistar male rats received 3 mg/kg of STZ and [18F]FDG PET images were acquired before and 7 days after STZ injection. Animals were treated with intraperitoneal cannabidiol (20 mg/kg—STZ–cannabidiol) or saline (STZ–saline) for one week. Novel object recognition was performed to evaluate short-term and long-term memory. [18F]FDG uptake in the whole brain was significantly lower in the STZ–saline group. Voxel-based analysis revealed a hypometabolism cluster close to the lateral ventricle, which was smaller in STZ–cannabidiol animals. The brain regions with more evident hypometabolism were the striatum, motor cortex, hippocampus, and thalamus, which was not observed in STZ–cannabidiol animals. In addition, STZ–cannabidiol animals revealed no changes in memory index. Thus, this study suggests that cannabidiol could be an early treatment for the neurodegenerative process observed in AD.
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Affiliation(s)
- Daniele de Paula Faria
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (L.E.d.S.); (C.A.B.)
- Correspondence: (D.d.P.F.); (C.C.R.)
| | - Larissa Estessi de Souza
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (L.E.d.S.); (C.A.B.)
| | - Fabio Luis de Souza Duran
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (F.L.d.S.D.); (G.B.F.)
| | - Carlos Alberto Buchpiguel
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (L.E.d.S.); (C.A.B.)
| | - Luiz Roberto Britto
- Institute of Biomedical Science, University of Sao Paulo, Sao Paulo 05508-000, SP, Brazil;
| | - José Alexandre de Souza Crippa
- Department of Neuroscience and Behavioral Sciences, Ribeirão Preto Medical School, University of Sao Paulo, Ribeirão Preto 14051-160, SP, Brazil;
| | - Geraldo Busatto Filho
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (F.L.d.S.D.); (G.B.F.)
| | - Caroline Cristiano Real
- Laboratory of Nuclear Medicine (LIM 43), Department of Radiology, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (L.E.d.S.); (C.A.B.)
- Laboratory of Psychiatric Neuroimaging (LIM 21), Department of Psychiatry, Faculdade de Medicina, University of Sao Paulo, Sao Paulo 05403-911, SP, Brazil; (F.L.d.S.D.); (G.B.F.)
- Correspondence: (D.d.P.F.); (C.C.R.)
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22
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Klebermass EM, Mahmudi M, Geist BK, Pichler V, Vraka C, Balber T, Miller A, Haschemi A, Viernstein H, Rohr-Udilova N, Hacker M, Mitterhauser M. If It Works, Don't Touch It? A Cell-Based Approach to Studying 2-[ 18F]FDG Metabolism. Pharmaceuticals (Basel) 2021; 14:ph14090910. [PMID: 34577610 PMCID: PMC8467898 DOI: 10.3390/ph14090910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/04/2021] [Accepted: 09/06/2021] [Indexed: 11/28/2022] Open
Abstract
The glucose derivative 2-[18F]fluoro-2-deoxy-D-glucose (2-[18F]FDG) is still the most used radiotracer for positron emission tomography, as it visualizes glucose utilization and energy demand. In general, 2-[18F]FDG is said to be trapped intracellularly as 2-[18F]FDG-6-phosphate, which cannot be further metabolized. However, increasingly, this dogma is being questioned because of publications showing metabolism beyond 2-[18F]FDG-6-phosphate and even postulating 2-[18F]FDG imaging to depend on the enzyme hexose-6-phosphate dehydrogenase in the endoplasmic reticulum. Therefore, we aimed to study 2-[18F]FDG metabolism in the human cancer cell lines HT1080, HT29 and Huh7 applying HPLC. We then compared 2-[18F]FDG metabolism with intracellular tracer accumulation, efflux and the cells’ metabolic state and used a graphical Gaussian model to visualize metabolic patterns. The extent of 2-[18F]FDG metabolism varied considerably, dependent on the cell line, and was significantly enhanced by glucose withdrawal. However, the metabolic pattern was quite conserved. The most important radiometabolites beyond 2-[18F]FDG-6-phosphate were 2-[18F]FDMannose-6-phosphate, 2-[18F]FDG-1,6-bisphosphate and 2-[18F]FD-phosphogluconolactone. Enhanced radiometabolite formation under glucose reduction was accompanied by reduced efflux and mirrored the cells’ metabolic switch as assessed via extracellular lactate levels. We conclude that there can be considerable metabolism beyond 2-[18F]FDG-6-phosphate in cancer cell lines and a comprehensive understanding of 2-[18F]FDG metabolism might help to improve cancer research and tumor diagnosis.
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Affiliation(s)
- Eva-Maria Klebermass
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
- Division of Pharmaceutical Technology and Biopharmaceutics, Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria;
| | - Mahshid Mahmudi
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
| | - Barbara Katharina Geist
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
| | - Verena Pichler
- Division of Pharmaceutical Chemistry, Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria;
| | - Chrysoula Vraka
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
| | - Theresa Balber
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
- Ludwig Boltzmann Institute Applied Diagnostics, 1090 Vienna, Austria
| | - Anne Miller
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria; (A.M.); (A.H.)
| | - Arvand Haschemi
- Department of Laboratory Medicine, Medical University of Vienna, 1090 Vienna, Austria; (A.M.); (A.H.)
| | - Helmut Viernstein
- Division of Pharmaceutical Technology and Biopharmaceutics, Department of Pharmaceutical Sciences, University of Vienna, 1090 Vienna, Austria;
| | - Nataliya Rohr-Udilova
- Division of Gastroenterology and Hepatology, Department of Internal Medicine III, Medical University of Vienna, 1090 Vienna, Austria;
| | - Marcus Hacker
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
| | - Markus Mitterhauser
- Division of Nuclear Medicine, Department of Biomedical Imaging and Image-Guided Therapy, Medical University of Vienna, 1090 Vienna, Austria; (E.-M.K.); (M.M.); (B.K.G.); (C.V.); (T.B.); (M.H.)
- Ludwig Boltzmann Institute Applied Diagnostics, 1090 Vienna, Austria
- Correspondence:
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23
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Wang R, Fan Q, Tian R, Su M. Intrapatient repeatability of background 18F-FDG uptake on PET/CT. Quant Imaging Med Surg 2021; 11:4172-4180. [PMID: 34476197 DOI: 10.21037/qims-20-769] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 04/23/2021] [Indexed: 02/05/2023]
Abstract
Background Background activity is often used as a reference to assess tumor treatment response on positron emission tomography with 2-deoxy-2-[fluorine-18] fluoro-D-glucose integrated with computed tomography (18F-FDG PET/CT). Our objective was to find the preferred background by assessing the repeatability of its activity. The activity was expressed by a standardized uptake value normalized to lean body mass (SUL). Methods Patients who received repeat 18F-FDG PET/CT scans within 1 to 4 days were selected. The indications included cancer screening, tumor staging, or treatment response evaluation. Background SULs from the aortic blood pool (ABP), liver, and muscle were recorded. Intraclass correlation coefficients (ICCs), the coefficient of variation (CV), and Bland-Altman plots for repeated measures were used to evaluate the degree of repeatability between the two scans. Intrapatient variation in SULs and factors, including the blood glucose level (BGL), tracer uptake period, and dose, were calculated as relative changes between the two scans. A linear regression model was used to analyze all relative changes to identify the correlation between factors and SULs. Results Thirty patients were included. The SUL ICCs for the ABP, liver, and muscle were 0.65 (95% CI, 0.38-0.81), 0.47 (95% CI, 0.15-0.70), and 0.82 (95% CI, 0.65-0.91), respectively. The SUL coefficients of variation (CVs) were 9% for the ABP, 12% for the liver, and 10% for muscle. Similar results were obtained from the Bland-Altman plots. There was a positive correlation between the variations in the liver SUL and the BGL (b=0.60, P<0.01). A similar result was found between the variations in muscle SUL and the BGL (b=0.45, P<0.01). The variation in muscle SUL showed a positive correlation with the variation in the tracer uptake period (b=0.58, P<0.01). Conclusions The SUL of the liver is more sensitive to BGLs and, therefore, may not be suitable as a referential background. Activities within the ABP and muscle are more stable than those of the liver and should be used as the preferred background for sequential patient evaluation.
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Affiliation(s)
- Rang Wang
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Qiuping Fan
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Tian
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
| | - Minggang Su
- Department of Nuclear Medicine, West China Hospital, Sichuan University, Chengdu, China
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Arslan E, Çermik TF. PET/CT Variants and Pitfalls in Liver, Biliary Tract, Gallbladder and Pancreas. Semin Nucl Med 2021; 51:502-518. [PMID: 34049687 DOI: 10.1053/j.semnuclmed.2021.04.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
A wide variety of pathological anomalies may occur in the liver, biliary system, and pancreas. It is a necessity to use many different imaging techniques in order to distinguish such varied pathologies, especially those from malignant processes. Positron Emission Tomography/Computed Tomography (PET/CT) is an imaging method that has proven its diagnostic value in oncology and can be used for different clinical purposes. Fluoro-18 fluoro-2-deoxy-D-glucose has a wide range of uses as a dominant radiopharmaceutical in routine molecular imaging, however, molecular imaging has started to play a more important role in personalized cancer treatment in recent years with new Fluoro-18 and Gallium-68 labeled tracers. Although molecular imaging has a strong diagnostic effect, the surprises and pitfalls of molecular imaging can lead us to unexpected and misleading results. Prior to PET/CT analysis and reporting, information about possible technical and physiological pitfalls, normal histological features of tissues, inflammatory pathologies, specific clinical features of the case, treatment-related complications and past treatments should be evaluated in advance to avoid misinterpretation. In this review, the physiological and pathophysiological variants as well as pitfalls encountered in PET/CT imaging of the liver, biliary tract, gallbladder, and pancreas will be examined. Other benign and malignant pathologies that have been reported to date and that have led to incorrect evaluation will be listed. It is expected that the devices, software, and artificial intelligence applications that will be developed in the near future will enable much more effective and faster imaging that will reduce the potential causes of error. However, as a result of the dynamic and evolving structure of the information obtained by molecular imaging, the inclusion of the newly developed radiopharmaceuticals in routine practice will continue to carry new potentials as well as new troubles. Although molecular imaging will be the flagship of diagnostic oncology in the 21st century, the correct analysis and interpretation by the physician will continue to form the basis of achieving optimal performance.
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Affiliation(s)
- Esra Arslan
- Istanbul Training and Research Hospital, Clinic of Nuclear Medicine, University of Health and Sciences Turkey, Istanbul, Turkey.
| | - Tevfik Fikret Çermik
- Istanbul Training and Research Hospital, Clinic of Nuclear Medicine, University of Health and Sciences Turkey, Istanbul, Turkey
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25
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Bochiński A, Sujenthiran A, Al-Hussini M, Fruhwirth GO, Shabbir M, Yap T. 18 F-FDG PET/CT use in functional assessment of the testes: A systematic review. Andrology 2021; 9:1410-1421. [PMID: 34019736 DOI: 10.1111/andr.13042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 04/29/2021] [Accepted: 05/18/2021] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Our study analysed previous studies employing positron emission tomography with co-registered computer tomography (PET/CT) in andrological patient evaluation and assessed the differences in 2-[18 F]F-fluoro-2'-deoxyglucose (FDG) uptake between three groups: healthy testes, benign and malignant testicular pathology. METHODS Medline and Embase were systematically searched for studies involving FDG-PET/CT imaging of testes with results expressed as mean standardised uptake value (SUVmean ). A one-way ANOVA was used to compare SUVmean between three groups. All papers assessing andrological parameters were pooled to compare fertility data. RESULTS Seventeen studies, including three relating to fertility diagnosis, with a total of 830 patients, were included in the review. One-way ANOVA showed a statistical difference between mean values of tracer SUVmean in healthy and malignant testes (Dif. = -2.77, 95% CI = -4.32 to 1.21, p < 0.01) as well as benign and malignant (Dif. = -2.95, 95% CI = -4.33 to -1.21, p < 0.01) but no difference between healthy and benign (Dif. = 0.19, 95% CI = -0.96 to 1.33, p = 0.90). There is some evidence to suggest that FDG uptake and testicular volume are positively correlated to total sperm count, sperm concentration and sperm motility and that germ cells are likely to account for the majority of testicular FDG accumulation. CONCLUSION Our findings indicate that malignant testicular lesions demonstrate a significantly higher FDG uptake than benign testicular lesions or healthy testes. Some evidence also suggests that FDG-PET could visualise metabolic activity and thus spermatogenesis; however more studies are required to determine whether FDG-PET could also be used to diagnose infertility. Further studies should focus on correlating both sex hormone-serum levels and semen analysis results with imaging data.
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Affiliation(s)
- Antoni Bochiński
- School of Bioscience Education, Guy's Campus, King's College London, London, UK
| | | | | | - Gilbert O Fruhwirth
- Imaging Therapies and Cancer Group, School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Majed Shabbir
- Department of Urology, Guy's and St Thomas' NHS Trust, London, UK
| | - Tet Yap
- Department of Urology, Guy's and St Thomas' NHS Trust, London, UK
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26
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Lee J, Park HY, Kim WW, Park CS, Lee RK, Kim HJ, Kim WH, Lee SW, Jeong SY, Chae YS, Lee SJ, Park JY, Park JY, Jung JH. Value of accurate diagnosis for metastatic supraclavicular lymph nodes in breast cancer: assessment with neck US, CT, and 18F-FDG PET/CT. ACTA ACUST UNITED AC 2021; 27:323-328. [PMID: 34003120 DOI: 10.5152/dir.2021.20190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
PURPOSE Neck ultrasonography (US), computed tomography (CT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) are all known to be useful imaging modalities for detecting supraclavicular lymph node (SCN) metastasis in breast cancer. The authors compared the diagnostic values of neck US, CT, and PET/CT in the detection of SCN metastasis in breast cancer. METHODS SCN metastases identified in neck US, CT, or PET/CT during follow-up visits of patients with breast cancer were pathologically confirmed with the use of US-guided fine-needle aspiration cytology. The clinicopathological factors of the patients were analyzed, and the statistical parameters including sensitivity, specificity, positive and negative predictive values, false-positive and false-negative rates, and accuracy of neck US, CT, and PET/CT were compared. RESULTS Among 32 cases of suspicious SCNs, 24 were pathologically confirmed as metastasis of breast cancer. The sensitivity of US + CT was 91.7%, which was the same as that of PET/CT, while the sensitivity rates of US alone and CT alone were 87.5% and 83.3%, respectively. Accuracy was 99.8% in PET/CT alone and 98.1% in US + CT. The false-negative rate was 0.1% in US + PET/CT, while it was 0.2% in PET/CT and US + CT, 0.3% in US alone and 0.4% in CT alone. CONCLUSION PET/CT can be the first choice for detecting SCN metastases in breast cancer. However, if PET/CT is unavailable for any reason, US + CT could be a good second option to avoid false-negative results.
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Affiliation(s)
- Jeeyeon Lee
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Ho Yong Park
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Wan Wook Kim
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Chan Sub Park
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Ryu Kyung Lee
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Hye Jung Kim
- Department of Radiology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Won Hwa Kim
- Department of Radiology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Sang Woo Lee
- Department of Nuclear Medicine, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Shin Young Jeong
- Department of Nuclear Medicine, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Yee Soo Chae
- Department of Hemato-Oncology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Soo Jung Lee
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea;Department of Hemato-Oncology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Ji Young Park
- Department of Pathology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jee-Young Park
- Department of Pathology, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
| | - Jin Hyang Jung
- Department of Surgery, Kyungpook National University School of Medicine, Kyungpook National University Chilgok Hospital, Daegu, Republic of Korea
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Hirata K, Tamaki N. Quantitative FDG PET Assessment for Oncology Therapy. Cancers (Basel) 2021; 13:cancers13040869. [PMID: 33669531 PMCID: PMC7922629 DOI: 10.3390/cancers13040869] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 02/15/2021] [Accepted: 02/16/2021] [Indexed: 12/12/2022] Open
Abstract
Simple Summary PET enables quantitative assessment of tumour biology in vivo. Accumulation of F-18 fluorodeoxyglucose (FDG) may reflect tumour metabolic activity. Quantitative assessment of FDG uptake can be applied for treatment monitoring. Numerous studies indicated biochemical change assessed by FDG-PET as a more sensitive marker than morphological change. Those with complete metabolic response after therapy may show better prognosis. Assessment of metabolic change may be performed using absolute FDG uptake or metabolic tumour volume. More recently, radiomics approaches have been applied to FDG PET. Texture analysis quantifies intratumoral heterogeneity in a voxel-by-voxel basis. Combined with various machine learning techniques, these new quantitative parameters hold a promise for assessing tissue characterization and predicting treatment effect, and could also be used for future prognosis of various tumours. Abstract Positron emission tomography (PET) has unique characteristics for quantitative assessment of tumour biology in vivo. Accumulation of F-18 fluorodeoxyglucose (FDG) may reflect tumour characteristics based on its metabolic activity. Quantitative assessment of FDG uptake can often be applied for treatment monitoring after chemotherapy or chemoradiotherapy. Numerous studies indicated biochemical change assessed by FDG PET as a more sensitive marker than morphological change estimated by CT or MRI. In addition, those with complete metabolic response after therapy may show better disease-free survival and overall survival than those with other responses. Assessment of metabolic change may be performed using absolute FDG uptake in the tumour (standardized uptake value: SUV). In addition, volumetric parameters such as metabolic tumour volume (MTV) have been introduced for quantitative assessment of FDG uptake in tumour. More recently, radiomics approaches that focus on image-based precision medicine have been applied to FDG PET, as well as other radiological imaging. Among these, texture analysis extracts intratumoral heterogeneity on a voxel-by-voxel basis. Combined with various machine learning techniques, these new quantitative parameters hold a promise for assessing tissue characterization and predicting treatment effect, and could also be used for future prognosis of various tumours, although multicentre clinical trials are needed before application in clinical settings.
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Affiliation(s)
- Kenji Hirata
- Department of Diagnostic Imaging, Graduate School of Medicine, Hokkaido University, Sapporo 060-8638, Japan;
| | - Nagara Tamaki
- Department of Radiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan
- Correspondence:
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28
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Rabben HL, Andersen GT, Olsen MK, Øverby A, Ianevski A, Kainov D, Wang TC, Lundgren S, Grønbech JE, Chen D, Zhao CM. Neural signaling modulates metabolism of gastric cancer. iScience 2021; 24:102091. [PMID: 33598644 PMCID: PMC7869004 DOI: 10.1016/j.isci.2021.102091] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Revised: 11/23/2020] [Accepted: 01/18/2021] [Indexed: 12/15/2022] Open
Abstract
Tumors comprise cancer cells and the associated stromal and immune/inflammatory cells, i.e., tumor microenvironment (TME). Here, we identify a metabolic signature of human and mouse model of gastric cancer and show that vagotomy in the mouse model reverses the metabolic reprogramming, reflected by metabolic switch from glutaminolysis to OXPHOS/glycolysis and normalization of the energy metabolism in cancer cells and TME. We next identify and validate SNAP25, mTOR, PDP1/α-KGDH, and glutaminolysis as drug targets and accordingly propose a therapeutic strategy to target the nerve-cancer metabolism. We demonstrate the efficacy of nerve-cancer metabolism therapy by intratumoral injection of BoNT-A (SNAP25 inhibitor) with systemic administration of RAD001 and CPI-613 but not cytotoxic drugs on overall survival in mice and show the feasibility in patients. These findings point to the importance of neural signaling in modulating the tumor metabolism and provide a rational basis for clinical translation of the potential strategy for gastric cancer. Metabolic reprogramming in gastric cancer cells and tumor microenvironment SNAP25, mTOR, PDP1/α-KGDH, and glutaminolysis as potential drug targets Combination of botulinum toxin type A, RAD001, and CPI-613 as a potential treatment
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Affiliation(s)
- Hanne-Line Rabben
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.,The Central Norway Regional Health Authority, Norway
| | - Gøran Troseth Andersen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Magnus Kringstad Olsen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Anders Øverby
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Aleksandr Ianevski
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Denis Kainov
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Timothy Cragin Wang
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.,Division of Digestive and Liver Diseases, Columbia University College of Physicians and Surgeons, New York, NY 10032-3802, USA
| | - Steinar Lundgren
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.,Cancer Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Jon Erik Grønbech
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.,Surgical Clinic, St. Olavs Hospital, Trondheim University Hospital, 7006 Trondheim, Norway
| | - Duan Chen
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway
| | - Chun-Mei Zhao
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology (NTNU), 7491 Trondheim, Norway.,The Central Norway Regional Health Authority, Norway
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29
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Recommendations for Standardizing Thorax PET-CT in Non-Human Primates by Recent Experience from Macaque Studies. Animals (Basel) 2021; 11:ani11010204. [PMID: 33467761 PMCID: PMC7830664 DOI: 10.3390/ani11010204] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 01/11/2021] [Accepted: 01/13/2021] [Indexed: 02/07/2023] Open
Abstract
Despite the possibilities of routine clinical measures and assays on readily accessible bio-samples, it is not always essential in animals to investigate the dynamics of disease longitudinally. In this regard, minimally invasive imaging methods provide powerful tools in preclinical research. They can contribute to the ethical principle of gathering as much relevant information per animal as possible. Besides, with an obvious parallel to clinical diagnostic practice, such imaging platforms are potent and valuable instruments leading to a more refined use of animals from a welfare perspective. Non-human primates comprise highly relevant species for preclinical research to enhance our understanding of disease mechanisms and/or the development of improved prophylactic or therapeutic regimen for various human diseases. In this paper, we describe parameters that critically affect the quality of integrated positron emission tomography and computed tomography (PET-CT) in non-human primates. Lessons learned are exemplified by results from imaging experimental infectious respiratory disease in macaques; specifically tuberculosis, influenza, and SARS-CoV-2 infection. We focus on the thorax and use of 18F-fluorodeoxyglucose as a PET tracer. Recommendations are provided to guide various stages of PET-CT-supported research in non-human primates, from animal selection, scan preparation, and operation, to processing and analysis of imaging data.
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Cao Y, Zhou K, Diao W, Long X, Tian F, Su M, Jia Z. Age-related changes of standardized uptake values in the blood pool and liver: a decade-long retrospective study of the outcomes of 2,526 subjects. Quant Imaging Med Surg 2021; 11:95-106. [PMID: 33392014 DOI: 10.21037/qims-20-35] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Background Background activity on fluorine-18-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography (PET/CT) is often used as a reference to assess a patient's response to tumor treatment. To produce a suitable background activity reference, we examined the variations in standardized uptake values (SUVs) in the blood pool and liver of a large multi-aged population. Methods A total of 2,526 subjects underwent 18F-FDG PET/CT examinations and were divided into 12 age groups. Pearson's partial correlation and multivariate regression analyses were performed to assess the associations between individual factors and SUVs of the blood pool and liver and to identify the factor that most influenced the SUVs. The mean SUVs across the age groups were also determined. Results Positive correlations were found between individual factors and SUVs. Age appeared to be the most important predictor of SUVs and was significantly associated with the blood pool SUVmax (ß=0.466, P=0.000), blood pool SUVmean (ß=0.393, P=0.000), liver SUVmax (ß=0.347, P=0.000), and liver SUVmean (ß=0.354, P=0.000). Blood pool and liver SUVs rose rapidly until the age of 20 and then showed a slow upward trend without reaching a plateau. Conclusions Age is an important factor that influences variations in the blood pool and liver SUVs. Our study clarified this understanding of age-related variations in SUVs and provided a normal range of blood pool and liver SUVs that may aid clinicians in evaluating tumors with greater accuracy.
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Affiliation(s)
- Yuan Cao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Ke Zhou
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Wei Diao
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Xipeng Long
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Fangfang Tian
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Minggang Su
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
| | - Zhiyun Jia
- Department of Nuclear Medicine, West China Hospital of Sichuan University, Chengdu, China
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Alonge KM, D'Alessio DA, Schwartz MW. Brain control of blood glucose levels: implications for the pathogenesis of type 2 diabetes. Diabetologia 2021; 64:5-14. [PMID: 33043401 PMCID: PMC7718404 DOI: 10.1007/s00125-020-05293-3] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/10/2020] [Indexed: 12/22/2022]
Abstract
Despite a rapidly growing literature, the role played by the brain in both normal glucose homeostasis and in type 2 diabetes pathogenesis remains poorly understood. In this review, we introduce a framework for understanding the brain's essential role in these processes based on evidence that the brain, like the pancreas, is equipped to sense and respond to changes in the circulating glucose level. Further, we review evidence that glucose sensing by the brain plays a fundamental role in establishing the defended level of blood glucose, and that defects in this control system contribute to type 2 diabetes pathogenesis. We also consider the possibility that the close association between obesity and type 2 diabetes arises from a shared defect in the highly integrated neurocircuitry governing energy homeostasis and glucose homeostasis. Thus, whereas obesity is characterised by an increase in the defended level of the body's fuel stores (e.g. adipose mass), type 2 diabetes is characterised by an increase in the defended level of the body's available fuel (e.g. circulating glucose), with the underlying pathogenesis in each case involving impaired sensing of (or responsiveness to) relevant humoral negative feedback signals. This perspective is strengthened by growing preclinical evidence that in type 2 diabetes the defended level of blood glucose can be restored to normal by therapies that restore the brain's ability to properly sense the circulating glucose level. Graphical abstract.
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Affiliation(s)
- Kimberly M Alonge
- UW Medicine Diabetes Institute, University of Washington, Seattle, WA, USA
| | - David A D'Alessio
- Duke Division of Endocrinology, Department of Medicine, Duke University Medical Center, Durham, NC, USA
| | - Michael W Schwartz
- UW Medicine Diabetes Institute, University of Washington, Seattle, WA, USA.
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Increased 18F-FDG accumulation in less-affected lung area in patients with non-small cell lung cancer and postoperative acute exacerbation of interstitial lung disease. Eur J Radiol 2020; 135:109477. [PMID: 33401111 DOI: 10.1016/j.ejrad.2020.109477] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/25/2020] [Accepted: 12/09/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE To investigate whether or not 18F-FDG accumulation in normal or less-affected lung fields increased in non-small cell lung cancer (NSCLC) patients with postoperative acute exacerbation (PAE) of interstitial lung disease (ILD) MATERIAL AND METHODS: Thirty-six NSCLC patients with ILD and 50 patients without ILD (non-ILD patients) underwent pre-operative 18F-FDG-PET/CT at 2 institutions. Volume-of-interest (VOI) was placed to measure the mean standardized uptake value (SUVmean) in normal or less-affected lung fields at pre-defined 12 areas on ventral and dorsal locations of both lungs. SUVtissue fraction (TF) was defined as corrected SUVmean by using TF and mean computed tomography density on PET/CT. Harmonized SUVmean (hSUVmean) and SUVTF (hSUVTF) were calculated based on results of phantom study, which was performed to optimize the measured SUV difference among 2 institutions. Both the h-SUVmean and the h-SUVTF were compared between 8 patients with PAE of ILD (PAE group) or remaining 28 patients without PAE of ILD (non-PAE group) and non-ILD patients in each of the 12 areas. RESULTS The hSUVmean in PAE group was higher in 9 out of 12 locations as compared with non-ILD patients, whereas the hSUVmean was mostly similar between non-PAE group and non-ILD patients. In contrast, the hSUVTF in non-PAE group was similar to that in PAE group, and higher than in non-ILD patients in most locations. CONCLUSION 18F-FDG-PET/CT demonstrated increased SUVmean along with elevated SUVTF in normal or less-affected lung fields for NSCLC patients with PAE of ILD, which may reflect regional invisible fibrosis and inflammatory change.
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McHugh CT, Garside J, Barkes J, Frank J, Dragicevich C, Yuan H, Branca RT. Differences in [ 18F]FDG uptake in BAT of UCP1 -/- and UCP1 +/+ during adrenergic stimulation of non-shivering thermogenesis. EJNMMI Res 2020; 10:136. [PMID: 33159596 PMCID: PMC7648812 DOI: 10.1186/s13550-020-00726-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 10/27/2020] [Indexed: 01/29/2023] Open
Abstract
BACKGROUND Brown adipose tissue (BAT) is a fat tissue found in most mammals that helps regulate energy balance and core body temperature through a sympathetic process known as non-shivering thermogenesis. BAT activity is commonly detected and quantified in [18F]FDG positron emission tomography/computed tomography (PET/CT) scans, and radiotracer uptake in BAT during adrenergic stimulation is often used as a surrogate measure for identifying thermogenic activity in the tissue. BAT thermogenesis is believed to be contingent upon the expression of the protein UCP1, but conflicting results have been reported in the literature concerning [18F]FDG uptake within BAT of mice with and without UCP1. Differences in animal handling techniques such as feeding status, type of anesthetic, type of BAT stimulation, and estrogen levels were identified as possible confounding variables for [18F]FDG uptake. In this study, we aimed to assess differences in BAT [18F]FDG uptake between wild-type and UCP1-knockout mice using a protocol that minimizes possible variations in BAT stimulation caused by different stress responses to mouse handling. RESULTS [18F]FDG PET/CT scans were run on mice that were anesthetized with pentobarbital after stimulation of non-shivering thermogenesis by norepinephrine. While in wild-type mice [18F]FDG uptake in BAT increased significantly with norepinephrine stimulation of BAT, there was no consistent change in [18F]FDG uptake in BAT of mice lacking UCP1. CONCLUSIONS [18F]FDG uptake within adrenergically stimulated BAT of wild-type and UCP1-knockout mice can significantly vary such that an [18F]FDG uptake threshold cannot be used to differentiate wild-type from UCP1-knockout mice. However, while an increase in BAT [18F]FDG uptake during adrenergic stimulation is consistently observed in wild-type mice, in UCP1-knockout mice [18F]FDG uptake in BAT seems to be independent of β3-adrenergic stimulation of non-shivering thermogenesis.
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Affiliation(s)
- Christian T McHugh
- Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - John Garside
- Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jared Barkes
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jonathan Frank
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Constance Dragicevich
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Hong Yuan
- Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Radiology, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Rosa T Branca
- Department of Physics and Astronomy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. .,Biomedical Research Imaging Center, The University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
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Zhao Q, Zhou J, Pan Y, Ju H, Zhu L, Liu Y, Zhang Y. The difference between steroid diabetes mellitus and type 2 diabetes mellitus: a whole-body 18F-FDG PET/CT study. Acta Diabetol 2020; 57:1383-1393. [PMID: 32647998 PMCID: PMC7547981 DOI: 10.1007/s00592-020-01566-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Accepted: 06/26/2020] [Indexed: 12/22/2022]
Abstract
AIMS Steroid diabetes mellitus (SDM) is a metabolic syndrome caused by an increase in glucocorticoids, and its pathogenesis is unclear. 18F-FDG PET/CT can reflect the glucose metabolism of tissues and organs under living conditions. Here, PET/CT imaging of SDM and type 2 diabetes mellitus (T2DM) rats was used to visualize changes in glucose metabolism in the main glucose metabolizing organs and investigate the pathogenesis of SDM. METHODS SDM and T2DM rat models were established. During this time, PET/CT imaging was used to measure the %ID/g value of skeletal muscle and liver to evaluate glucose uptake. The pancreatic, skeletal muscle and liver were analyzed by immunohistochemistry. RESULTS SDM rats showed increased fasting blood glucose and insulin levels, hyperplasia of islet α and β cells, increased FDG uptake in skeletal muscle accompanied by an up-regulation of PI3Kp85α, IRS-1, and GLUT4, no significant changes in liver uptake, and that glycogen storage in the liver and skeletal muscle increased. T2DM rats showed atrophy of pancreatic islet β cells and decreased insulin levels, significantly reduced FDG uptake and glycogen storage in skeletal muscle and liver. CONCLUSIONS The pathogenesis of SDM is different from that of T2DM. The increased glucose metabolism of skeletal muscle may be related to the increased compensatory secretion of insulin. Glucocorticoids promote the proliferation of islet α cells and cause an increase in gluconeogenesis in the liver, which may cause increased blood glucose.
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Affiliation(s)
- Qingqing Zhao
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Jinxin Zhou
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yu Pan
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Huijun Ju
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Liying Zhu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yang Liu
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China
| | - Yifan Zhang
- Department of Nuclear Medicine, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai, 200025, China.
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Clinical feasibility and impact of fully automated multiparametric PET imaging using direct Patlak reconstruction: evaluation of 103 dynamic whole-body 18F-FDG PET/CT scans. Eur J Nucl Med Mol Imaging 2020; 48:837-850. [DOI: 10.1007/s00259-020-05007-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 08/18/2020] [Indexed: 12/22/2022]
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Wang C, Zhao K, Hu S, Huang Y, Ma L, Li M, Song Y. The PET-Derived Tumor-to-Liver Standard Uptake Ratio (SUV TLR ) Is Superior to Tumor SUVmax in Predicting Tumor Response and Survival After Chemoradiotherapy in Patients With Locally Advanced Esophageal Cancer. Front Oncol 2020; 10:1630. [PMID: 33014819 PMCID: PMC7494965 DOI: 10.3389/fonc.2020.01630] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2019] [Accepted: 07/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background: The maximum standardized uptake values (SUVmax) derived from 18F-fluorodeoxy-glucose positron emission tomography/computed tomography (18F-FDG PET/CT) have some well-known shortcomings in predicting treatment response and prognosis in oncology. The standardized SUVmax with an appropriate reference background may overcome this problem in some instances. This study explored the prognostic value of the tumor-to-liver SUVmax ratio (SUVTLR) and the tumor-to-blood pool SUVmax ratio (SUVTBR) in predicting the objective response (OR) and overall survival (OS) in patients with locally advanced esophageal cancer after concurrent chemoradiotherapy (CCRT). Methods: We retrospectively analyzed 128 newly diagnosed esophageal squamous cell carcinoma (ESCC) patients who were treated with CCRT. The SUVmax of primary tumor, SUVTLR, SUVTBR and clinicopathologic features data were analyzed. Univariate and multivariate analyses were used to determine the predictors of tumor response. Survival analysis was performed using the Kaplan–Meier method and Cox proportional hazards model. Results: Receiver operating characteristic (ROC) curve analysis demonstrated that SUVTLR was superior to SUVmax and SUVTBR in predicting treatment response. Univariate and multivariate analyses revealed that advanced tumor stage (hazard ratio [HR] = 9.67; 95% CI: 1.15-81.28; P = 0.037) and high SUVTLR (HR = 21.92; 95% CI: 2.26-212.96; P = 0.008) were independent predictors of poor treatment response. Cox regression analysis showed that good clinical tumor response (p < 0.014, HR =0.501; 95% CI: 0.288–0.871) was a favorable independent predictive factor for OS, while an advanced tumor stage (p = 0.018, HR = 1.796; 95% CI: 1.107-2.915) and a high SUVTLR (p < 0.002, HR = 2.660; 95% CI: 1.425–4.967) were prognostic factors for poor OS. The median OS of patients in the low SUVTLR and high SUVTLR groups was 13.47 vs. 19.30 months, respectively. Conclusions: PET-derived SUVTLR is superior to tumor SUVmax and SUVTBR in predicting treatment response and overall survival in patients with ESCC undergoing CCRT. High SUVTLR was an independent predictor of poor treatment response and shorter overall survival.
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Affiliation(s)
- Chunsheng Wang
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Kewei Zhao
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China.,Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Shanliang Hu
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
| | - Yong Huang
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Li Ma
- Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Minghuan Li
- Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong University, Jinan, China
| | - Yipeng Song
- Department of Radiation Oncology, Qingdao University Medical College Affiliated Yantai Yuhuangding Hospital, Yantai, China
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Different Effects of Transcranial Direct Current Stimulation on Leg Muscle Glucose Uptake Asymmetry in Two Women with Multiple Sclerosis. Brain Sci 2020; 10:brainsci10080549. [PMID: 32823504 PMCID: PMC7465960 DOI: 10.3390/brainsci10080549] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Revised: 08/11/2020] [Accepted: 08/12/2020] [Indexed: 12/17/2022] Open
Abstract
Asymmetrical lower limb strength is a significant contributor to impaired walking abilities in people with multiple sclerosis (PwMS). Transcranial direct current stimulation (tDCS) may be an effective technique to enhance cortical excitability and increase neural drive to more-affected lower limbs. A sham-controlled, randomized, cross-over design was employed. Two women with MS underwent two 20 min sessions of either 3 mA tDCS or Sham before 20 min of treadmill walking at a self-selected speed. During walking, the participants were injected with the glucose analogue, [18F] fluorodeoxyglucose (FDG). Participants were then imaged to examine glucose metabolism and uptake asymmetries in the legs. Standardized uptake values (SUVs) were compared between the legs and asymmetry indices were calculated. Subject 2 was considered physically active (self-reported participating in at least 30 min of moderate-intensity physical activity on at least three days of the week for the last three months), while Subject 1 was physically inactive. In Subject 1, there was a decrease in SUVs at the left knee flexors, left upper leg, left and right plantar flexors, and left and right lower legs and SUVs in the knee extensors and dorsiflexors were considered symmetric after tDCS compared to Sham. Subject 2 showed an increase in SUVs at the left and right upper legs, right plantar flexors, and right lower leg with no muscle group changing asymmetry status. This study demonstrates that tDCS may increase neural drive to leg muscles and decrease glucose uptake during walking in PwMS with low physical activity levels.
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Kim D, Ko HY, Lee S, Lee YH, Ryu S, Kim SY, Chung JI, Lee M, Moon JH, Chang JH, Yun M. Glucose Loading Enhances the Value of 18F-FDG PET/CT for the Characterization and Delineation of Cerebral Gliomas. Cancers (Basel) 2020; 12:cancers12071977. [PMID: 32698507 PMCID: PMC7409292 DOI: 10.3390/cancers12071977] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 07/15/2020] [Accepted: 07/17/2020] [Indexed: 12/14/2022] Open
Abstract
This study aimed to assess how to enhance the value of 18F-Fluorodeoxyglucose (FDG) PET/CTs for glioma grading and better delineation of the tumor boundary by glucose loading. In mouse models of brain tumor using U87MG cells, 18F-FDG-PET images were obtained after fasting and after glucose loading. There was a significant difference in the tumor-to-normal cortex-uptake ratio (TNR) between the fasting and glucose-loading scans. 14C-2-Deoxy-D-glucose (14C-DG) uptake was measured in vitro using U87MG, U373MG and primary neurons cultured with different concentrations of glucose. The tumor-to-neuron ratio of 14C-DG uptake increased with up to 10 mM of glucose. Finally, 10 low-grade and 17 high-grade glioma patients underwent fasting and glucose loading 18F-FDG PET/CT and the TNR was compared between scans. The effect of glucose loading was significant in high-grade but not in low-grade gliomas. The receiver operating characteristic curve analyses with a cut-off TNR of 0.81 showed a higher area under the curve after glucose loading than fasting for differentiating low-grade versus high-grade gliomas. In addition, the glucose loading PET/CT was more useful than the fasting PET/CT for the discrimination of oligodendrogliomas from IDH-wildtype glioblastomas. Glucose loading resulted in a greater reduction in 18F-FDG uptake in the normal cortex than in tumors, which increases the usefulness of 18F-FDG PET/CT for grading.
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Affiliation(s)
- Dongwoo Kim
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
| | - Hae Young Ko
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
| | - Sangwon Lee
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
| | - Yong-ho Lee
- Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea;
| | - Sujin Ryu
- Brain Tumor Center, Severance Hospital, Yonsei University Health System, Seoul 03722, Korea;
| | - Seon Yoo Kim
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
| | - Jee-in Chung
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
| | - Misu Lee
- Division of Life Sciences, College of Life Science and Bioengineering, Incheon National University, Incheon 22012, Korea;
| | - Ju Hyung Moon
- Department of Neurosurgery, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (J.H.M.); (J.H.C.)
| | - Jong Hee Chang
- Department of Neurosurgery, Brain Tumor Center, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (J.H.M.); (J.H.C.)
| | - Mijin Yun
- Department of Nuclear Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul 03722, Korea; (D.K.); (H.Y.K.); (S.L.); (S.Y.K.); (J.-i.C.)
- Correspondence: ; Tel.: +82-2-2228-6068
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Young PNE, Estarellas M, Coomans E, Srikrishna M, Beaumont H, Maass A, Venkataraman AV, Lissaman R, Jiménez D, Betts MJ, McGlinchey E, Berron D, O'Connor A, Fox NC, Pereira JB, Jagust W, Carter SF, Paterson RW, Schöll M. Imaging biomarkers in neurodegeneration: current and future practices. Alzheimers Res Ther 2020; 12:49. [PMID: 32340618 PMCID: PMC7187531 DOI: 10.1186/s13195-020-00612-7] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 04/01/2020] [Indexed: 12/12/2022]
Abstract
There is an increasing role for biological markers (biomarkers) in the understanding and diagnosis of neurodegenerative disorders. The application of imaging biomarkers specifically for the in vivo investigation of neurodegenerative disorders has increased substantially over the past decades and continues to provide further benefits both to the diagnosis and understanding of these diseases. This review forms part of a series of articles which stem from the University College London/University of Gothenburg course "Biomarkers in neurodegenerative diseases". In this review, we focus on neuroimaging, specifically positron emission tomography (PET) and magnetic resonance imaging (MRI), giving an overview of the current established practices clinically and in research as well as new techniques being developed. We will also discuss the use of machine learning (ML) techniques within these fields to provide additional insights to early diagnosis and multimodal analysis.
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Affiliation(s)
- Peter N E Young
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mar Estarellas
- Centre for Medical Image Computing (CMIC), Department of Computer Science & Department of Medical Physics and Biomedical Engineering, University College London, London, UK
| | - Emma Coomans
- Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Meera Srikrishna
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Helen Beaumont
- Neuroscience and Aphasia Research Unit, Division of Neuroscience and Experimental Psychology, The University of Manchester, Manchester, UK
| | - Anne Maass
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Ashwin V Venkataraman
- Division of Brain Sciences, Imperial College London, London, UK
- United Kingdom Dementia Research Institute, Imperial College London, London, UK
| | - Rikki Lissaman
- Cardiff University Brain Research Imaging Centre (CUBRIC), School of Psychology, Cardiff, UK
| | - Daniel Jiménez
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
- Department of Neurological Sciences, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Matthew J Betts
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany
| | | | - David Berron
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Antoinette O'Connor
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Joana B Pereira
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - William Jagust
- Helen Wills Neuroscience Institute, University of California, Berkeley, USA
- Molecular Biophysics and Integrated Bioimaging, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Stephen F Carter
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, UK
- Wolfson Molecular Imaging Centre, Division of Neuroscience and Experimental Psychology, MAHSC, University of Manchester, Manchester, UK
| | - Ross W Paterson
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK
| | - Michael Schöll
- Wallenberg Centre for Molecular and Translational Medicine and the Department of Psychiatry and Neurochemistry, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden.
- Dementia Research Centre, UCL Institute of Neurology, University College London, London, UK.
- Department of Clinical Physiology, Sahlgrenska University Hospital, Gothenburg, Sweden.
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40
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Blautzik J, Grelich L, Schramm N, Henkel R, Bartenstein P, Pfluger T. What and how should we measure in paediatric oncology FDG-PET/CT? Comparison of commonly used SUV metrics for differentiation between paediatric tumours. EJNMMI Res 2019; 9:115. [PMID: 31872312 PMCID: PMC6928180 DOI: 10.1186/s13550-019-0577-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 11/19/2019] [Indexed: 12/15/2022] Open
Abstract
Background In clinical routine, SUVmax and SUVpeak are most often used to determine the glucose metabolism in tumours by 18F-FDG PET/CT. Both metrics can be further normalised to SUVs in reference regions resulting in a SUV ratio (SUVratio). The aim of the study was to directly compare several widely used SUVs/SUVratios with regard to differentiation between common tumours in paediatric patients; a special focus was put on characteristics of reference region SUVs. Methods The final study population consisted of 61 children and adolescents with diagnoses of non-Hodgkin lymphoma (NHL, n = 25), Hodgkin lymphoma (HL, n = 14), and sarcoma (n = 22). SUV metrics included SUVmax and SUVpeak as well as both parameters normalised to liver and mediastinal blood pool, respectively, yielding the SUVratios SUVmax/liver, SUVmax/mediastinum, SUVpeak/liver, and SUVpeak/mediastinum. Results The metrics SUVmax, SUVpeak, SUVmax/liver, and SUVpeak/liver all proved to be sensitive for tumour differentiation (p ≤ 0.008); in contrast, SUVmax/mediastinum and SUVpeak/mediastinum revealed to be non-sensitive approaches. Correlation analyses showed inverse associations between reference region SUVs and SUVratios (p < 0.05). Multiple regression analyses demonstrated significant effects of factors as bodyweight and uptake time on reference region SUVs (p < 0.01), and thus indirectly on the corresponding SUVratios. Conclusions In the paediatric population, the ability to differentiate between common tumours remarkably varies between SUV metrics. When using SUVratios, the choice of reference region is crucial. Factors potentially influencing reference region SUVs (and thus SUVratios) should be taken into account in order to avoid erroneous conclusions. When not possible, SUVmax and SUVpeak represent less complex, more robust alternatives.
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Affiliation(s)
- Janusch Blautzik
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany. .,Department of Radiology, University Hospital, LMU Munich, Munich, Germany. .,Institute for Radiology and Nuclear Medicine, Hirslanden Klinik St. Anna, Lucerne, Switzerland.
| | - Leonie Grelich
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Nicolai Schramm
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,Department of Nuclear Medicine, University Hospital, Würzburg, Germany
| | - Rebecca Henkel
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany.,Department of Radiology, University Hospital, LMU Munich, Munich, Germany
| | - Peter Bartenstein
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Thomas Pfluger
- Department of Nuclear Medicine, University Hospital, LMU Munich, Munich, Germany
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Zhang CE, Staals J, van Oostenbrugge RJ, Vink H. Uncoupling of Microvascular Blood Flow and Capillary Density in Vascular Cognitive Impairment. Front Neurol 2019; 10:1268. [PMID: 31849826 PMCID: PMC6901497 DOI: 10.3389/fneur.2019.01268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2019] [Accepted: 11/15/2019] [Indexed: 12/14/2022] Open
Abstract
Cerebral small vessel disease (cSVD) plays an important role in dementia and is a major cause for vascular cognitive impairment (VCI). Recent studies hypothesized that capillary dysfunction including reduction of capillary patency, rather than a flow-limiting pathology is crucial in cSVD. As cSVD is considered a systemic microvascular disease, we examined sublingual microvascular blood flow and capillary density in patients with VCI and controls. Fifteen patients with VCI due to cSVD and 15 controls underwent intravital microscopy of the sublingual microvessels. Microvascular blood flow and capillary density in high and low flow areas were determined for each participant. Flow-density coupling was examined by determining the ratio of density changes to flow changes, and the ratio of feed vessel red blood cell (RBC) velocity to capillary RBC velocity. These were compared between VCI and controls. In healthy controls, capillary density increased proportionally with feed vessel blood flow increase. In patients with VCI, no increase of capillary density was observed. Moreover, increase of feed vessel RBC velocity led to significant increase of capillary RBC velocity in VCI, whereas in controls, the capillary RBC increased only slightly. Flow-density coupling differed significantly between VCI and controls, also after correcting for age and hypertension. Our findings suggest uncoupling of microvascular blood flow and capillary density in patients with VCI. This uncoupling may impair oxygen and nutrients exchange when blood flow increases in response to increased metabolic demand, ultimately leading to tissue damage.
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Affiliation(s)
- Chenxing Eleana Zhang
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.,CARIM and MHeNs, Maastricht University Medical Center, Maastricht, Netherlands
| | - Julie Staals
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.,CARIM and MHeNs, Maastricht University Medical Center, Maastricht, Netherlands
| | - Robert Jan van Oostenbrugge
- Department of Neurology, Maastricht University Medical Center, Maastricht, Netherlands.,CARIM and MHeNs, Maastricht University Medical Center, Maastricht, Netherlands
| | - Hans Vink
- CARIM and MHeNs, Maastricht University Medical Center, Maastricht, Netherlands.,Department of Physiology, Maastricht University Medical Center, Maastricht, Netherlands
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42
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Management of hyperglycemia in oncological patients scheduled for an FDG-PET/CT examination. Clin Transl Imaging 2019. [DOI: 10.1007/s40336-019-00347-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
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43
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Altun Tuzcu S, Cetin F, Pekkolay Z, Tuzcu A. 18F-FLUORODEOXYGLUCOSE PET/CT CAN BE AN ALTERNATIVE METHOD TO ASSESSMENT OF INSULIN RESISTANCE. ACTA ENDOCRINOLOGICA (BUCHAREST, ROMANIA : 2005) 2019; 15:539-543. [PMID: 32377256 PMCID: PMC7200103 DOI: 10.4183/aeb.2019.539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Insulin resistance is routinely measured by homeostasis model assessment of insulin resistance (HOMA-IR).Positron emission tomography of 18F-fluorodeoxyglucose combined with computed tomography (18F-FDG PET/CT) is a valuable assessment tool for patients with cancer or staging tumors. 18F-FDG PET/CT imaging can also be utilised to detect the metabolic activity of glucose in the adipose tissue, liver and muscles. The aim of this study was to determine insulin sensitivity in the liver, muscle visceral adipose and subcutaneous adipose tissue separately via18F-FDG PET/CT. MATERIALS AND METHOD Sixty three adult patients who underwent whole body 18F-FDG PET/CT scanning for clinical purposes (diagnosis or staging of cancer) between July and August of 2016 were included in the study. Patients were divided into two groups according to their BMI (Group 1: BMI<25kg/m2, Group 2: BMI>25kg/m2). HOMA-IR,fasting glucose,insulin, triglycerides, total cholesterol, HDL levels were measured. We calculated SUV as the tissue activity of the ROI (MBq/g)/(injected dose [MBq]/ body weight [g]) on PET images and measured the maximum SUVs (SUVmax) of visceral adipose tissue (VAT) and subcutaneous adipose tissue (SAT),liver and rectus muscle ROIs (2 cm). SUV corrected by blood glucose level (SUVgluc) was calculated as SUVmax×blood glucose level/100. Student-t test, Chi-square test and Pearson correlation test were used for statistical analysis. RESULTS Mean glucose,insulin,HOMA-IR levels of the group-2 were statistically higher than of group-1. Muscle SUVmax and liver SUVmax of group-1 were statistically higher than of group-2. Muscle SUVgluc of group-1 was statistically higher than of group-2. HOMA-IR was negatively correlated with both SUVmax(r=-0.340, p=0.01) and muscle SUVmax(r=-0.373, p=0.005). CONCLUSION 18F-FDG PET/CT has shown that the muscle tissue maximum FDG uptake was lower in the insulin resistance group. Therefore, 18-FDG PET/CT could be a valuable tool for diagnosing insulin resistance.
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Affiliation(s)
- S. Altun Tuzcu
- Dicle University Department of Nuclear Medicine, Diyarbakir, Turkey
| | - F.A. Cetin
- Private Baglara Hospital - Radiology, Diyarbakir, Turkey
| | - Z. Pekkolay
- Dicle University - Endocrinology, Diyarbakir, Turkey
| | - A.K. Tuzcu
- Dicle University - Endocrinology, Diyarbakir, Turkey
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44
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Effect of drugs containing glucose on FDG-PET image quality. Ann Nucl Med 2019; 33:828-834. [DOI: 10.1007/s12149-019-01394-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2019] [Accepted: 08/05/2019] [Indexed: 10/26/2022]
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45
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Waqas K, van Haard PMM, Postema JWA, Schweitzer DH. Diabetes Mellitus-Related Fractional Glucose Uptake in Men and Women Imaged With 18F-FDG PET-CT. J Endocr Soc 2019; 3:773-783. [PMID: 30963135 PMCID: PMC6446889 DOI: 10.1210/js.2019-00001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Accepted: 02/22/2019] [Indexed: 11/19/2022] Open
Abstract
CONTEXT Cohort studies show that cognitive dysfunction and both vascular and Alzheimer's dementia are more common in patients with type 2 diabetes mellitus (T2DM). OBJECTIVE To review and compare brain volume and 18F-fluorodeoxyglucose (FDG) uptake in brain of individuals age 60 to 70 years with or without type 2 diabetes. DESIGN We searched 620 medical records for negative 18FDG PET-CT scans obtained during 33 months. Records showing history of cognitive impairment, Alzheimer's disease, neurologic disorders, any history of brain atrophy, or documented cerebral infarction on neuroimaging were excluded from the study. RESULTS A total of 119 medical records met the inclusion criteria. Data from 63 women and 56 men (without T2DM, 86; with T2DM, 33) were analyzed. Brain volume was larger in men than women (mean ± SD, 1411 ± 225 cm3 vs 1325 ± 147 cm3, respectively; P = 0.02), but men had a significantly lower fractional glucose uptake (SUVgluc), calculated as fasting blood glucose × SUVmax. [median (minimum, maximum), 63.6 (34.6, 126.6) vs 70.0 (36.4, 134.3); P = 0.02]. Brain volume was also larger in persons without T2DM than in those with T2DM (1392 ± 172 cm3 vs 1269 ± 183 cm3; P < 0.001), but SUVgluc was similar between these groups. Brain volume correlated with SUVgluc in both men and women overall (P < 0.001) but not in men and women with T2DM (P = 0.20 and 0.36, respectively). CONCLUSION In men without T2DM, median brain volume was larger and fractional glucose uptake was less than in women without T2DM. In men and women with T2DM, brain volume and fractional glucose uptake were similar. The findings support the hypothesis that fractional glucose uptake becomes impaired in men with T2DM.
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Affiliation(s)
- Komal Waqas
- Department of Internal Medicine and Endocrinology, Reinier the Graaf Hospital, Delft, Netherlands
| | - Paul M M van Haard
- Department of Medical Laboratories, Association of Clinical Chemistry, Reinier the Graaf Hospital, Delft, Netherlands
| | - Jan W A Postema
- Department of Nuclear Medicine, Reinier de Graaf Gasthuis, Delft, Netherlands
| | - Dave H Schweitzer
- Department of Internal Medicine and Endocrinology, Reinier the Graaf Hospital, Delft, Netherlands
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Lu T, Zhan C, Huang Y, Zhao M, Yang X, Ge D, Shi Y, Wang Q. Small pulmonary granuloma is often misdiagnosed as lung cancer by positron emission tomography/computer tomography in diabetic patients. Interact Cardiovasc Thorac Surg 2019; 28:394-398. [PMID: 30165660 DOI: 10.1093/icvts/ivy263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/21/2018] [Accepted: 07/28/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES A small pulmonary granuloma (SPG) is often misdiagnosed as lung cancer in diabetic patients by positron emission tomography/computed tomography (PET/CT). The present study was conducted to investigate whether diabetes is the influencing factor and to determine other related factors that have an impact on the diagnostic results following PET/CT examination. METHODS All clinical, imaging and pathological data of patients diagnosed with pulmonary nodules by PET/CT from January 2004 to December 2017 in our department were collected. Patients with an SPG who were wrongly diagnosed with lung cancer by PET/CT were enrolled (n = 79). The propensity score matching method was used to create a comparable control adenocarcinoma group (n = 395). Maximum standard uptake values, diabetes and fasting blood-glucose (FBG) were determined and analysed. RESULTS The average maximum standard uptake values in the 2 groups were comparable (P = 0.801). Maximum standard uptake values in 5 subsections were not significantly different between the 2 groups (P = 0.135). The odds ratio (OR) of 3.326 [95% confidence interval (CI) 1.671-6.623] for diabetes favoured misdiagnosis and was statistically significant (P < 0.001). Furthermore, in patients with high FBG levels (≥7.0 mmol/l), the risk of misdiagnosis of SPG increased significantly compared with normal FBG level (OR 2.601, 95% CI 1.174-5.761; P = 0.015). CONCLUSIONS Diabetes and high FBG level were the influencing factors in the false-positive results of lung cancer by PET/CT examination.
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Affiliation(s)
- Tao Lu
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Cheng Zhan
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yiwei Huang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Mengnan Zhao
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xiaodong Yang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Di Ge
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yu Shi
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Qun Wang
- Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China
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Is the effect of hyperglycemia on liver 18F-FDG standardized uptake value really clinically significant? Eur J Nucl Med Mol Imaging 2019; 46:1216-1217. [PMID: 30806749 DOI: 10.1007/s00259-019-04288-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 02/06/2019] [Indexed: 10/27/2022]
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48
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18F-FDG uptake in the normal appendix in adults: PET/CT evaluation. Ann Nucl Med 2019; 33:265-268. [PMID: 30652242 DOI: 10.1007/s12149-019-01330-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/04/2019] [Indexed: 01/24/2023]
Abstract
OBJECTIVE This study aimed to determine the level of 18F fluorodeoxyglucose (18F-FDG) activity in the normal adult appendix using positron emission tomography/computed tomography (PET/CT). MATERIALS AND METHODS We performed a retrospective review of PET/CT images using 18F-FDG in 563 consecutive asymptomatic adult patients without appendiceal pathology. We excluded 257 patients for an undetected or obscured appendix and three patients for appendicitis found on CT imaging. FDG uptake in the appendix was qualitatively and quantitatively assessed. The maximum standardized uptake value (SUVmax) was calculated for quantitative analysis with SUVmax of the normal liver for comparison. A total of 303 patients (200 males, 103 females, mean age of 66 years) were included in this study. Medical charts and histories were evaluated for patients who showed positive FDG accumulation. Pearson's correlations between appendiceal SUVmax and age, body mass index, and blood glucose levels were analyzed. RESULTS The mean appendiceal SUVmax was 1.14 (range 0.52-5.12) with an appendix-to-liver SUVmax ratio of 0.34 (range 0.06-1.28). Three patients qualitatively showed a positive FDG accumulation with appendiceal SUVmax greater than 3.00. There were no correlations between appendiceal SUVmax and age, body mass index, or blood glucose levels. CONCLUSIONS FDG in the normal adult appendix shows a low activity level and is lower compared with normal liver. However, the normal appendix can rarely show high FDG accumulation. In such cases, differentiation from appendiceal pathology solely by PET/CT images would be difficult.
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Buture A, Boland JW, Dikomitis L, Ahmed F. Update on the pathophysiology of cluster headache: imaging and neuropeptide studies. J Pain Res 2019; 12:269-281. [PMID: 30655693 PMCID: PMC6324919 DOI: 10.2147/jpr.s175312] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE Cluster headache (CH) is the most severe primary headache condition. Its pathophysiology is multifaceted and incompletely understood. This review brings together the latest neuroimaging and neuropeptide evidence on the pathophysiology of CH. METHODS A review of the literature was conducted by searching PubMed and Web of Science. The search was conducted using the following keywords: imaging studies, voxel-based morphometry, diffusion-tensor imaging, diffusion magnetic resonance imaging, tractography, connectivity, cerebral networks, neuromodulation, central modulation, deep brain stimulation, orexin-A, orexin-B, tract-based spatial statistics, single-photon emission computer tomography studies, positron-emission tomography, functional magnetic resonance imaging, magnetic resonance spectroscopy, trigeminovascular system, neuropeptides, calcitonin gene-related peptide, neurokinin A, substance P, nitric oxide synthase, pituitary adenylate cyclase-activating peptide, vasoactive intestinal peptide, neuropeptide Y, acetylcholine, noradrenaline, and ATP. "Cluster headache" was combined with each keyword for more relevant results. All irrelevant and duplicated records were excluded. Search dates were from October 1976 to May 2018. RESULTS Neuroimaging studies support the role of the hypothalamus in CH, as well as other brain areas involved in the pain matrix. Activation of the trigeminovascular system and the release of neuropeptides play an important role in CH pathophysiology. Among neuropeptides, calcitonin gene-related peptide, vasoactive intestinal peptide, and pituitary adenylate cyclase-activating peptide have been reported to be reliable biomarkers for CH attacks, though not specific for CH. Several other neuropeptides are involved in trigeminovascular activation, but the current evidence does not qualify them as reliable biomarkers in CH. CONCLUSION CH has a complex pathophysiology and the pain mechanism is not completely understood. Recent neuroimaging studies have provided insight into the functional and structural network bases of CH pathophysiology. Although there has been important progress in neuropeptide studies, a specific biomarker for CH is yet to be found.
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Affiliation(s)
- Alina Buture
- Department of Neurology, Hull Royal Infirmary, Hull, UK,
- Hull York Medical School, University of Hull, Hull, UK,
| | | | - Lisa Dikomitis
- School of Medicine and Institute of Primary Care and Health Sciences, Keele University, Newcastle, UK
| | - Fayyaz Ahmed
- Department of Neurology, Hull Royal Infirmary, Hull, UK,
- Hull York Medical School, University of Hull, Hull, UK,
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50
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Choi YS, Kang S, Ko SY, Lee S, Kim JY, Lee H, Song JE, Kim DH, Kim E, Kim CH, Saksida L, Song HT, Lee JE. Hyperpolarized [1-13C] pyruvate MR spectroscopy detect altered glycolysis in the brain of a cognitively impaired mouse model fed high-fat diet. Mol Brain 2018; 11:74. [PMID: 30563553 PMCID: PMC6299662 DOI: 10.1186/s13041-018-0415-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/26/2018] [Indexed: 01/08/2023] Open
Abstract
Higher dietary intakes of saturated fatty acid increase the risk of developing Alzheimer’s disease and dementia, and even in people without diabetes higher glucose levels may be a risk factor for dementia. The mechanisms causing neuronal dysfunction and dementia by consuming high-fat diet degrading the integrity of the blood-brain barrier (BBB) has been suggested but are not yet fully understood, and metabolic state of the brain by this type of insult is still veiled. The objective of this study was to investigate the effect of high-fat diet on the brain metabolism by a multimodal imaging method using the hyperpolarizedcarbon 13 (13C)-pyruvate magnetic resonance (MR) spectroscopy and dynamic contrast-enhanced MR imaging in conjunction with the biochemical assay and the behavior test in a mouse model fed high-fat diet (HFD). In mice were fed 60% HFD for 6 months, hyperpolarized [1-13C] pyruvate MR spectroscopy showed decreased perfusion (p < 0.01) and increased conversion from pyruvate to lactate (p < 0.001) in the brain. The hippocampus and striatum showed the highest conversion ratio. The functional integrity of the blood-brain barrier tested by dynamic contrast-enhanced MR imaging showed no difference to the control. Lactate was increased in the cortex (p < 0.01) and striatum (p < 0.05), while PDH activity was decreased in the cortex (p < 0.01) and striatum (p < 0.001) and the phosphorylated PDH was increased in the striatum (p < 0.05). Mice fed HFD showed less efficiency in learning memory compared with control (p < 0.05). To determine whether hyperpolarized 13C-pyruvate magnetic resonance (MR) spectroscopy could detect a much earier event in the brain. Mice fed HFD for 3 months did not show a detectable cognitive decline in water maze based learning memory. Hyperpolarized [1-13C] pyruvate MR spectroscopy showed increased lactate conversion (P < .001), but no difference in cerebral perfusion. These results suggest that the increased hyperpolarized [1-13C] lactate signal in the brain of HFD-fed mice represent that altered metabolic alteration toward to glycolysis and hypoperfusion by the long-term metabolic stress by HFD further promote to glycolysis. The hyperpolarized [1-13C] pyruvate MR spectroscopy can be used to monitor the brain metabolism and will provide information helpful to understand the disease process.
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Affiliation(s)
- Young-Suk Choi
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Somang Kang
- Department of Anatomy, BK21 Project for Medical Science and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Sang-Yoon Ko
- Department of Anatomy, BK21 Project for Medical Science and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Saeram Lee
- Department of Anatomy, BK21 Project for Medical Science and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Jae Young Kim
- Department of Anatomy, BK21 Project for Medical Science and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea
| | - Hansol Lee
- Department of Electrical and Electronic Engineering, Yonsei University, Seoul, 03722, South Korea
| | - Jae Eun Song
- Department of Electrical and Electronic Engineering, Yonsei University, Seoul, 03722, South Korea
| | - Dong-Hyun Kim
- Department of Electrical and Electronic Engineering, Yonsei University, Seoul, 03722, South Korea
| | - Eosu Kim
- Department of Psychiatry, Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Chul Hoon Kim
- Department of Pharmacology, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.,BK21 PLUS Project for Medical Sciences and Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea
| | - Lisa Saksida
- Department of Psychology and MRC/Wellcome Trust Behavioural and Clinical Neuroscience Institute, University of Cambridge, Downing Street, Cambridge, CB2 3EB, UK.,Molecular Medicine Research Group, Robarts Research Institute & Department of Physiology and Pharmacology, Schulich School of Medicine & Dentistry, Western University, London, ON, Canada.,The Brain and Mind Institute, Western University, London, ON, Canada
| | - Ho-Taek Song
- Department of Radiology and Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
| | - Jong Eun Lee
- Department of Anatomy, BK21 Project for Medical Science and Research Institute of Radiological Science, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, Republic of Korea. .,BK21 PLUS Project for Medical Sciences and Brain Research Institute, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
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