nach oben

European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.06.2011 | Review Article

A new dimension of FDG-PET interpretation: assessment of tumor biology

verfasst von: Thomas C. Kwee, Sandip Basu, Babak Saboury, Valentina Ambrosini, Drew A. Torigian, Abass Alavi

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 6/2011

Einloggen, um Zugang zu erhalten

Abstract

¹⁸F-Fluoro-2-deoxy-d-glucose (FDG) positron emission tomography (PET) is increasingly being used for the evaluation of several malignancies. Key to the correct interpretation of oncological FDG-PET studies is awareness of the concept that the degree of FDG uptake reflects the biology of the tumor in many cancers. More specifically, cancers with high FDG uptake are often histologically and clinically more aggressive than those with low or no FDG uptake. Therefore, although a negative FDG-PET scan in a patient with a cancer that has a size above the spatial resolution of PET may be interpreted as false-negative in terms of tumor detectability, it should in fact be regarded as true-negative from the view-point of tumor biology. This nonsystematic review will give examples of several major cancers in which the relationship between FDG avidity and tumor biology is applicable, and emphasizes the need to reconsider the definition of a “false-negative” FDG-PET scan in clinical oncology.

Basu S, Alavi A. Unparalleled contribution of 18F-FDG PET to medicine over 3 decades. J Nucl Med. 2008;49:17N–21N, 37N.PubMedCrossRef

Rohren EM, Turkington TG, Coleman RE. Clinical applications of PET in oncology. Radiology. 2004;231:305–32.PubMedCrossRef

Gillies RJ, Robey I, Gatenby RA. Causes and consequences of increased glucose metabolism of cancers. J Nucl Med. 2008;49 Suppl 2:24S–42S.PubMedCrossRef

Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med. 2008;49:480–508.PubMedCrossRef

Jadvar H, Alavi A, Gambhir SS. 18F-FDG uptake in lung, breast, and colon cancers: molecular biology correlates and disease characterization. J Nucl Med. 2009;50:1820–7.PubMedCrossRef

Basu S, Kumar R, Mavi A, Alavi A. Exploring tumor biology with fluorodeoxyglucose-positron emission tomography imaging in breast carcinoma. PET Clin. 2009;4:381–9.CrossRef

Samson DJ, Flamm CR, Pisano ED, Aronson N. Should FDG PET be used to decide whether a patient with an abnormal mammogram or breast finding at physical examination should undergo biopsy? Acad Radiol. 2002;9:773–83.PubMedCrossRef

Kumar R, Chauhan A, Zhuang H, Chandra P, Schnall M, Alavi A. Clinicopathologic factors associated with false negative FDG-PET in primary breast cancer. Breast Cancer Res Treat. 2006;98:267–74.PubMedCrossRef

Basu S, Chen W, Tchou J, Mavi A, Cermik T, Czerniecki B, et al. Comparison of triple-negative and estrogen receptor-positive/progesterone receptor-positive/HER2-negative breast carcinoma using quantitative fluorine-18 fluorodeoxyglucose/positron emission tomography imaging parameters: a potentially useful method for disease characterization. Cancer. 2008;112:995–1000.PubMedCrossRef

10.

Jaskowiak CJ, Bianco JA, Perlman SB, Fine JP. Influence of reconstruction iterations on 18F-FDG PET/CT standardized uptake values. J Nucl Med. 2005;46:424–8.PubMed

11.

Wang W, Larson SM, Fazzari M, Tickoo SK, Kolbert K, Sgouros G, et al. Prognostic value of [18F]fluorodeoxyglucose positron emission tomographic scanning in patients with thyroid cancer. J Clin Endocrinol Metab. 2000;85:1107–13.PubMedCrossRef

12.

Robbins RJ, Wan Q, Grewal RK, Reibke R, Gonen M, Strauss HW, et al. Real-time prognosis for metastatic thyroid carcinoma based on 2-[18F]fluoro-2-deoxy-D-glucose-positron emission tomography scanning. J Clin Endocrinol Metab. 2006;91:498–505.PubMedCrossRef

13.

Weiler-Sagie M, Bushelev O, Epelbaum R, Dann EJ, Haim N, Avivi I, et al. (18)F-FDG avidity in lymphoma readdressed: a study of 766 patients. J Nucl Med. 2010;51:25–30.PubMedCrossRef

14.

Schöder H, Noy A, Gönen M, Weng L, Green D, Erdi YE, et al. Intensity of 18fluorodeoxyglucose uptake in positron emission tomography distinguishes between indolent and aggressive non-Hodgkin’s lymphoma. J Clin Oncol. 2005;23:4643–51.PubMedCrossRef

15.

Ngeow JY, Quek RH, Ng DC, Hee SW, Tao M, Lim LC, et al. High SUV uptake on FDG-PET/CT predicts for an aggressive B-cell lymphoma in a prospective study of primary FDG-PET/CT staging in lymphoma. Ann Oncol. 2009;20:1543–7.PubMedCrossRef

16.

Karam M, Ata A, Irish K, Feustel PJ, Mottaghy FM, Stroobants SG, et al. FDG positron emission tomography/computed tomography scan may identify mantle cell lymphoma patients with unusually favorable outcome. Nucl Med Commun. 2009;30:770–8.PubMedCrossRef

17.

Gallamini A, Hutchings M, Rigacci L, Specht L, Merli F, Hansen M, et al. Early interim 2-[18F]fluoro-2-deoxy-D-glucose positron emission tomography is prognostically superior to international prognostic score in advanced-stage Hodgkin’s lymphoma: a report from a joint Italian-Danish study. J Clin Oncol. 2007;25:3746–52.PubMedCrossRef

18.

Haioun C, Itti E, Rahmouni A, Brice P, Rain JD, Belhadj K, et al. [18F]fluoro-2-deoxy-D-glucose positron emission tomography (FDG-PET) in aggressive lymphoma: an early prognostic tool for predicting patient outcome. Blood. 2005;106:1376–81.PubMedCrossRef

19.

Liu IJ, Zafar MB, Lai YH, Segall GM, Terris MK. Fluorodeoxyglucose positron emission tomography studies in diagnosis and staging of clinically organ-confined prostate cancer. Urology. 2001;57:108–11.PubMedCrossRef

20.

Sung J, Espiritu JI, Segall GM, Terris MK. Fluorodeoxyglucose positron emission tomography studies in the diagnosis and staging of clinically advanced prostate cancer. BJU Int. 2003;92:24–7.PubMedCrossRef

21.

Schöder H, Herrmann K, Gönen M, Hricak H, Eberhard S, Scardino P, et al. 2-[18F]fluoro-2-deoxyglucose positron emission tomography for the detection of disease in patients with prostate-specific antigen relapse after radical prostatectomy. Clin Cancer Res. 2005;11:4761–9.PubMedCrossRef

22.

Richter JA, Rodríguez M, Rioja J, Peñuelas I, Martí-Climent J, Garrastachu P, et al. Dual tracer 11C-choline and FDG-PET in the diagnosis of biochemical prostate cancer relapse after radical treatment. Mol Imaging Biol. 2010;12:210–7.PubMedCrossRef

23.

Oyama N, Akino H, Suzuki Y, Kanamaru H, Miwa Y, Tsuka H, et al. Prognostic value of 2-deoxy-2-[F-18]fluoro-D-glucose positron emission tomography imaging for patients with prostate cancer. Mol Imaging Biol. 2002;4:99–104.PubMedCrossRef

24.

Fiorentino M, Capizzi E, Loda M. Blood and tissue biomarkers in prostate cancer: state of the art. Urol Clin North Am. 2010;37:131–41.PubMedCrossRef

25.

Park JW, Kim JH, Kim SK, Kang KW, Park KW, Choi JI, et al. A prospective evaluation of 18F-FDG and 11C-acetate PET/CT for detection of primary and metastatic hepatocellular carcinoma. J Nucl Med. 2008;49:1912–21.PubMedCrossRef

26.

Hatano E, Ikai I, Higashi T, Teramukai S, Torizuka T, Saga T, et al. Preoperative positron emission tomography with fluorine-18-fluorodeoxyglucose is predictive of prognosis in patients with hepatocellular carcinoma after resection. World J Surg. 2006;30:1736–41.PubMedCrossRef

27.

Torizuka T, Tamaki N, Inokuma T, Magata Y, Sasayama S, Yonekura Y, et al. In vivo assessment of glucose metabolism in hepatocellular carcinoma with FDG-PET. J Nucl Med. 1995;36:1811–7.PubMed

28.

Krenning EP, Kwekkeboom DJ, Bakker WH, Breeman WA, Kooij PP, Oei HY, et al. Somatostatin receptor scintigraphy with [111In-DTPA-D-Phe1]- and [123I-Tyr3]-octreotide: the Rotterdam experience with more than 1000 patients. Eur J Nucl Med. 1993;20:716–31.PubMedCrossRef

29.

Hoegerle S, Altehoefer C, Ghanem N, Koehler G, Waller CF, Scheruebl H, et al. Whole-body 18F dopa PET for detection of gastrointestinal carcinoid tumors. Radiology. 2001;220:373–80.PubMed

30.

Gabriel M, Decristoforo C, Kendler D, Dobrozemsky G, Heute D, Uprimny C, et al. [68Ga]DOTA-Tyr3-octreotide PET in neuroendocrine tumors: comparison with somatostatin receptor scintigraphy and CT. J Nucl Med. 2007;48:508–18.PubMedCrossRef

31.

Campana D, Ambrosini V, Pezzilli R, Fanti S, Labate AM, Santini D, et al. Standardized uptake values of (68)Ga-DOTANOC PET: a promising prognostic tool in neuroendocrine tumors. J Nucl Med. 2010;51:353–9.PubMedCrossRef

32.

Ambrosini V, Campana D, Bodei L, Nanni C, Castellucci P, Allegri V, et al. 68Ga-DOTANOC PET/CT clinical impact in patients with neuroendocrine tumors. J Nucl Med. 2010;51:669–73.PubMedCrossRef

33.

Adams S, Baum R, Rink T, Schumm-Dräger PM, Usadel KH, Hör G. Limited value of fluorine-18 fluorodeoxyglucose positron emission tomography for the imaging of neuroendocrine tumors. Eur J Nucl Med. 1998;25:79–83.PubMedCrossRef

34.

Wild D, Mäcke HR, Waser B, Reubi JC, Ginj M, Rasch H, et al. [68Ga]DOTANOC: a first compound for PET imaging with high affinity for somatostatin receptor subtypes 2 and 5. Eur J Nucl Med Mol Imaging. 2005;32:724.PubMedCrossRef

35.

Binderup T, Knigge U, Loft A, Mortensen J, Pfeifer A, Federspiel B, et al. Functional imaging of neuroendocrine tumors: a head-to-head comparison of somatostatin receptor scintigraphy, 123I-MIBG scintigraphy, and 18F-FDG PET. J Nucl Med. 2010;51:704–12.PubMedCrossRef

36.

Binderup T, Knigge U, Loft A, Federspiel B, Kjaer A. 18F-fluorodeoxyglucose positron emission tomography predicts survival of patients with neuroendocrine tumors. Clin Cancer Res. 2010;16:978–85.PubMedCrossRef

37.

Garin E, Le Jeune F, Devillers A, Cuggia M, de Lajarte-Thirouard AS, Bouriel C, et al. Predictive value of 18F-FDG PET and somatostatin receptor scintigraphy in patients with metastatic endocrine tumors. J Nucl Med. 2009;50:858–64.PubMedCrossRef

38.

Rubello D, Rampin L, Nanni C, Banti E, Ferdeghini M, Fanti S, et al. The role of 18F-FDG PET/CT in detecting metastatic deposits of recurrent medullary thyroid carcinoma: a prospective study. Eur J Surg Oncol. 2008;34:581–6.PubMed

39.

Conry BG, Papathanasiou ND, Prakash V, Kayani I, Caplin M, Mahmood S, et al. Comparison of (68)Ga-DOTATATE and (18)F-fluorodeoxyglucose PET/CT in the detection of recurrent medullary thyroid carcinoma. Eur J Nucl Med Mol Imaging. 2010;37:49–57.PubMedCrossRef

40.

Higashi K, Ueda Y, Seki H, Yuasa K, Oguchi M, Noguchi T, et al. Fluorine-18-FDG PET imaging is negative in bronchioloalveolar lung carcinoma. J Nucl Med. 1998;39:1016–20.PubMed

41.

Goudarzi B, Jacene HA, Wahl RL. Diagnosis and differentiation of bronchioloalveolar carcinoma from adenocarcinoma with bronchioloalveolar components with metabolic and anatomic characteristics using PET/CT. J Nucl Med. 2008;49:1585–92.PubMedCrossRef

42.

Padma MV, Said S, Jacobs M, Hwang DR, Dunigan K, Satter M, et al. Prediction of pathology and survival by FDG PET in gliomas. J Neurooncol. 2003;64:227–37.PubMedCrossRef

43.

Kidd EA, Spencer CR, Huettner PC, Siegel BA, Dehdashti F, Rader JS, et al. Cervical cancer histology and tumor differentiation affect 18F-fluorodeoxyglucose uptake. Cancer. 2009;115:3548–54.PubMedCrossRef

44.

Kidd EA, Siegel BA, Dehdashti F, Grigsby PW. The standardized uptake value for F-18 fluorodeoxyglucose is a sensitive predictive biomarker for cervical cancer treatment response and survival. Cancer. 2007;110:1738–44.PubMedCrossRef

45.

Pan L, Gu P, Huang G, Xue H, Wu S. Prognostic significance of SUV on PET/CT in patients with esophageal cancer: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol. 2009;21:1008–15.PubMedCrossRef

46.

Kato H, Nakajima M, Sohda M, Tanaka N, Inose T, Miyazaki T, et al. The clinical application of (18)F-fluorodeoxyglucose positron emission tomography to predict survival in patients with operable esophageal cancer. Cancer. 2009;115:3196–203.PubMedCrossRef

47.

Sepesi B, Raymond DP, Polomsky M, Watson TJ, Litle VR, Jones CE, et al. Does the value of PET-CT extend beyond pretreatment staging? An analysis of survival in surgical patients with esophageal cancer. J Gastrointest Surg. 2009;13:2121–7.PubMedCrossRef

48.

Scully RE. International histological classification of tumors: histological typing of ovarian tumors. Geneva: World Health Organization; 1999.

49.

Nanni C, Rubello D, Farsad M, De Iaco P, Sansovini M, Erba P, et al. (18)F-FDG PET/CT in the evaluation of recurrent ovarian cancer: a prospective study on forty-one patients. Eur J Surg Oncol. 2005;31:792–7.PubMedCrossRef

50.

Havrilesky LJ, Kulasingam SL, Matchar DB, Myers ER. FDG-PET for management of cervical and ovarian cancer. Gynecol Oncol. 2005;97:183–91.PubMedCrossRef

51.

Kumar R, Alavi A. PET imaging in gynecologic malignancies. Radiol Clin North Am. 2004;42:1155–67.PubMedCrossRef

52.

Fenchel S, Grab D, Nuessle K, Kotzerke J, Rieber A, Kreienberg R, et al. Asymptomatic adnexal masses: correlation of FDG PET and histopathologic findings. Radiology. 2002;223:780–8.PubMedCrossRef

53.

Rieber A, Nüssle K, Stöhr I, Grab D, Fenchel S, Kreienberg R, et al. Preoperative diagnosis of ovarian tumors with MR imaging: comparison with transvaginal sonography, positron emission tomography, and histologic findings. AJR Am J Roentgenol. 2001;177:123–9.PubMed

54.

Woodward PJ, Hosseinzadeh K, Saenger JS. From the archives of the AFIP: radiologic staging of ovarian carcinoma with pathologic correlation. Radiographics. 2004;24:225–46.PubMedCrossRef

55.

Huang YT, Lee JC, Kumar AS. Variable F-18 fluorodeoxyglucose avidity of metastatic recurrent adult granulosa cell tumor. Clin Nucl Med. 2009;34:710–2.PubMedCrossRef

56.

Picchio M, Sironi S, Messa C, Mangili G, Landoni C, Gianolli L. Advanced ovarian carcinoma: usefulness of [(18)F]FDG-PET in combination with CT for lesion detection after primary treatment. Q J Nucl Med. 2003;47:77–84.PubMed

57.

Risum S, Høgdall C, Loft A, Berthelsen AK, Høgdall E, Nedergaard L, et al. The diagnostic value of PET/CT for primary ovarian cancer: a prospective study. Gynecol Oncol. 2007;105:145–9.PubMedCrossRef

58.

Yamamoto Y, Oguri H, Yamada R, Maeda N, Kohsaki S, Fukaya T. Preoperative evaluation of pelvic masses with combined 18F-fluorodeoxyglucose positron emission tomography and computed tomography. Int J Gynecol Obstet. 2008;102:124–7.CrossRef

59.

Jung DC, Choi HJ, Ju W, Kim SC, Choi KG. Discordant MRI/FDG-PET imaging for the diagnosis of borderline ovarian tumors. Int J Gynecol Cancer. 2008;18:637–41.PubMedCrossRef

60.

Schröder W, Zimny M, Rudlowski C, Bull U, Rath W. The role of 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) in diagnosis of ovarian cancer. Int J Gynecol Cancer. 1999;9:117–22.PubMedCrossRef

61.

Kurokawa T, Yoshida Y, Kawahara K, Tsuchida T, Okazawa H, Fujibayashi Y, et al. Expression of GLUT-1 glucose transfer, cellular proliferation activity and grade of tumor correlate with [F-18]-fluorodeoxyglucose uptake by positron emission tomography in epithelial tumors of the ovary. Int J Cancer. 2004;109:926–32.PubMedCrossRef

62.

Kalir T, Wang BY, Goldfischer M, Haber RS, Reder I, Demopoulos R, et al. Immunohistochemical staining of GLUT1 in benign, borderline, and malignant ovarian epithelia. Cancer. 2002;15:1078–82.CrossRef

Titel: A new dimension of FDG-PET interpretation: assessment of tumor biology
verfasst von: Thomas C. Kwee
Sandip Basu
Babak Saboury
Valentina Ambrosini
Drew A. Torigian
Abass Alavi
Publikationsdatum: 01.06.2011
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 6/2011
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-010-1713-9

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

A new dimension of FDG-PET interpretation: assessment of tumor biology

Abstract

Live-Webinar: Aktuelle Leitlinien bei Herz-Kreislauf-Erkrankungen

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 6/2011

Iterative reconstruction or filtered backprojection for semi-quantitative assessment of dopamine D2 receptor SPECT studies?

Synchronous malignancies in patients with squamous cell carcinomas of the oral cavity

Prognostic value of interim FDG PET/CT in Hodgkin’s lymphoma patients treated with interim response-adapted strategy: comparison of International Harmonization Project (IHP), Gallamini and London criteria

Value of the radiolabelled GLP-1 receptor antagonist exendin(9–39) for targeting of GLP-1 receptor-expressing pancreatic tissues in mice and humans

Erratum to: Focus on time-of-flight PET: the benefits of improved time resolution

Relationship between infarct size and severity measured by gated SPECT and long-term left ventricular remodelling after acute myocardial infarction