Department of Respiratory Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka city/Saitama, 350-1298, Japan.
Department of Nuclear Medicine, International Medical Center, Saitama Medical University, 1397-1 Yamane, Hidaka city/Saitama, 350-1298, Japan.
Cancer Imaging. 2024 Nov 18;24(1):157. doi: 10.1186/s40644-024-00800-w.
Two-deoxy-2-[fluorine-18]-fluoro-d-glucose (F-FDG) positron emission tomography (PET) is useful for detecting malignant lesions; however, the clinical significance of cardiac F-FDG uptake in patients with cancer remains unclear. This preliminary study explored the relationship between cardiac F-FDG uptake and advanced diseases such as cancer cachexia in non-small cell lung cancer (NSCLC).
Forty-three patients with advanced NSCLC who underwent F-FDG PET and complained of weight loss before the first-line systemic therapy were retrospectively included in this study. Visual assessment using a 5-point scale based on F-FDG uptake was performed; a cut-off score of 3 was determined, a low score was 1, 2, or 3, and a high score was 4 or 5).
High and low visual cardiac F-FDG uptakes were observed in 27 (62.8%) and 16 (37.2%) patients, respectively. Of the 43 patients, 17 (39.5%) definitely had cachexia, and 26 (60.5%) did not. A low visual score and standardized uptake value for cardiac F-FDG uptake were significantly associated with high metabolic tumor activity (p = 0.009, and p = 0.009, respectively) and a high neutrophil-to-lymphocyte ratio (p = 0.016, and p = 0.047, respectively), whereas a low visual score for cardiac F-FDG uptake and high metabolic tumor activity were significantly associated with cachexia (p = 0.004). The amount of cardiac F-FDG accumulation depicted a close relationship with body mass index, low weight loss, and inflammation. The combination of cachexia and low visual cardiac F-FDG uptake was identified as a significant predictor for poor overall survival (OS) (p = 0.034).
Decreased visual cardiac F-FDG uptake was associated with poor nutritional status and OS, and cachexia in patients with advanced NSCLC.
双脱氧-2-[氟-18]-氟代-d-葡萄糖（F-FDG）正电子发射断层扫描（PET）可用于检测恶性病变；然而，癌症患者心脏 F-FDG 摄取的临床意义仍不清楚。本初步研究探讨了心脏 F-FDG 摄取与晚期疾病（如非小细胞肺癌（NSCLC）中的癌症恶病质）之间的关系。
回顾性纳入 43 例在一线全身治疗前因体重减轻而接受 F-FDG PET 的晚期 NSCLC 患者。使用基于 F-FDG 摄取的 5 分制视觉评估进行评估；确定 3 分的截断值，低分为 1、2 或 3，高分为 4 或 5）。
在 43 例患者中，分别观察到高和低的视觉心脏 F-FDG 摄取的患者分别为 27（62.8%）和 16（37.2%）。在 43 例患者中，17 例（39.5%）肯定患有恶病质，而 26 例（60.5%）没有。低视觉评分和心脏 F-FDG 摄取的标准化摄取值与高代谢肿瘤活性（p=0.009 和 p=0.009）和高中性粒细胞与淋巴细胞比值（p=0.016 和 p=0.047）显著相关，而低视觉评分和高代谢肿瘤活性与恶病质显著相关（p=0.004）。心脏 F-FDG 摄取的累积量与体重指数、低体重减轻和炎症密切相关。恶病质和低视觉心脏 F-FDG 摄取的结合被确定为总生存期（OS）不良的显著预测因子（p=0.034）。
晚期 NSCLC 患者心脏 F-FDG 摄取减少与营养状况不良和 OS 差以及恶病质有关。
