Severe, diffuse decrease in global brain 18F-fluorodeoxxglucose uptake: association with whole-body total lesion glycolysis and short-term prognostic significance in elderly patients with newly diagnosed stage Ⅳ cancer
10.3760/cma.j.issn.0254-9026.2021.08.018
- VernacularTitle:初诊Ⅳ期老年肿瘤患者全脑皮质 18氟-氟代脱氧葡萄糖摄取与肿瘤糖酵解总量的相关性及近期预后意义初探
- Author:
Wenchan LI
1
;
Zhiming YAO
;
Fugeng LIU
;
Wen CHEN
;
Xiuqin LIU
;
Wenjie ZHANG
Author Information
1. 北京医院核医学科 国家老年医学中心 中国医学科学院老年医学研究院 100730
- Keywords:
Fluorodeoxyglucose F 18;
Cerebral cortex;
Neoplasms;
Glycoly
- From:
Chinese Journal of Geriatrics
2021;40(8):1025-1029
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the relationships between severe, diffuse decrease in global brain 18F-fluorodeoxxglucose(FDG)uptake, whole-body total lesion glycolysis(TLG)and short-term death in elderly patients with newly diagnosed stage Ⅳ cancer. Methods:Clinical and 18FFDG PET/CT data of 24 elderly patients newly diagnosed stage Ⅳ cancer showing marked diffuse decrease in global brain FDG uptake(the decreased brain uptake group)were retrospectively enrolled.Sixteen elderly patients with newly diagnosed stage Ⅳ cancer but without decreased global brain FDG uptake(the no decreased brain uptake group)and 25 healthy subjects were enrolled as the control groups.Correlations between brain FDG uptake and whole-body TLG were analyzed.We followed up the final outcomes of all patients and analyzed the short-term prognostic value of these manifestations. Results:The decreased brain uptake group included 17 patients with stage Ⅳ lymphoma and 7 patients with stage Ⅳ malignant tumor of other types[15 males, age: (73±9)years], while the no decreased brain uptake group included 8 patients with stage Ⅳ lymphoma and 8 patients with stage Ⅳ malignant tumor of other types[12 males, age: (65±5)years]and the healthy control group included 25 subjects[13 males, age: (65±6)years]. Patients were older in the decreased brain uptake group than in the no decreased brain uptake group( t=3.8, P=0.001). The global brain SUV means of the decreased brain uptake group and the no decreased brain uptake group were 4.9±1.8 and 10.9±2.0, respectively( t=-9.8, P=0.000). The global brain total glycolysis(TG)values of the two groups were 1786.5±1162.5 and 2868.4±1424.5, respectively( t=-2.6, P=0.012). The whole-body TLG values of the two groups were 6825.5±4776.9 and 2919.5±2031.7, respectively( t=3.6, P=0.001). Pearson correlation analysis showed that brain FDG uptake was adversely correlated with whole-body TLG.We followed up the survival outcomes of the two groups.The median follow-up lengths of the two groups were 6 months and 10 months, respectively( χ2=3.7, P=0.054). Fourteen(14/24)patients died in the decreased brain uptake group while 9(9/16)died in the no decreased brain uptake group( χ2=0.017, P=0.896). However, 8 cases died within 1 month post PET/CT scan in the decreased brain uptake group while none died in the no decreased brain uptake group( χ2=4.7, P=0.029). Conclusions:Severe, diffuse decrease in 18F-FDG PET/CT uptake in the whole cerebral cortex is more common in elderly patients with newly diagnosed stage Ⅳ cancer, whose total tumor load is significantly higher than that of cancer patients without decrease in whole cerebral cortex FDG uptake.This uptake reduction may indicate poor short-term outcome and the probability of short-term death may be high.
