Association between bone marrow fluorodeoxyglucose uptake and recurrence after curative surgical resection in patients with T1–2N0M0 lung adenocarcinoma: a retrospective cohort study

Abstract

Background: Evidence regarding the relationship between fluorodeoxyglucose (FDG) uptake in the bone marrow of patients with lung adenocarcinoma and prognosis is limited. This study aimed to identify whether bone marrow FDG uptake is a risk factor for recurrence in patients after curative surgical resection of T1-2N0M0 lung adenocarcinoma.Methods: From January 2012 to December 2016, we retrospectively enrolled 195 pT1-2N0M0 lung adenocarcinoma patients who underwent both preoperative FDG positron emission tomography/computed tomography (PET/CT) and surgical resection from the lung adenocarcinoma database maintained by the PET/CT department at our hospital. After surgical resection, patients were followed up mainly through regular outpatient examinations. The maximum standardized uptake value (SUV max ) of the primary tumor, the mean FDG uptake of bone marrow (BM SUV), bone marrow-liver uptake ratio (BLR), metabolic tumor volume (MTV), and total lesion glycolysis (TLG) were measured from the pretreatment FDG PET/CT images. Multi-adjusted Cox proportional hazards models were built to evaluate the independent prognostic value of BLR in predicting recurrence-free survival (RFS). A restricted cubic spline regression model was conducted to provide more precise estimates and examine the shape of the associations between BLR and the risk of recurrence.Results: The follow-up results showed that 30 of the 195 patients (15.4%) had tumor recurrence.Compared with non-recurrent patients, the primary tumor size in recurrent patients was larger, and the SUV max , TLG, and serum C-reactive protein (CRP) levels were higher. Univariate analysis showed that BLR, tumor size, SUV max , TLG, and CRP were significantly correlated with postoperative tumor recurrence. After adjustment for conventional confounding factors, the hazard ratio of BLR was 5.01 (95% CI, 1.32, 18.98) for the highest tertile of BLR compared with the lowest tertile. The multi-adjusted spline regression showed that BLR had a linear relationship with log relative risk (RR) for recurrence when BLR was lower than 0.7.Over this level, the effect stabilized, suggesting a saturation effect for BLR at a level of approximately 0.7 at recurrence.Conclusions: BLR was an independent risk factor for predicting RFS in T1-2N0M0 lung adenocarcinoma patients after curative surgical resection. BLR can be used as a biomarker for evaluating the risk of lung cancer recurrence.

Real-world multicentre analysis of neoadjuvant immunotherapy and chemotherapy in localized or oligometastatic non-small cell lung cancer (KOMPASSneoOP)

“…Whether PET scan might be helpful or whether circulating tumour DNA (ctDNA) analysis from peripheral blood is more sensitive should be investigated in future trials. 40 – 43 …”

Correlation between apparent diffusion coefficient and tumor-stroma ratio in hybrid 18F-FDG PET/MRI: preliminary results of a rectal cancer cohort study

“…The exclusion criteria were as follows: (I) intolerance of general anesthesia or severe heart, lung, liver, and other major organ dysfunction; (II) severe coagulation disorder; (III) pregnancy; (IV) abdominal cavity or pelvic metastasis; (V) tumor perforation or acute peritonitis; or (VI) preoperative chemotherapy or radiation therapy. All participants were examined preoperatively with whole-body 18 F-FDG PET/MRI. Rectal cancer surgeries were performed according to TME principles.…”

“…Apparent diffusion coefficient (ADC) values derived from DWI are quantified and, more recently, have been considered a potential imaging parameter of tumor aggressiveness in rectal cancer (14,15). Previous studies have shown that the intensity of fluorine-18-fluorodeoxyglucose ( 18 F-FDG) uptake by malignant tumors is correlated with more aggressive tumor behavior, and high 18 F-FDG uptake in the primary tumor indicates a less favorable outcome (16)(17)(18). Recently, positron emission tomography/magnetic resonance imaging (PET/MRI) has emerged as a novel imaging technology that combines the metabolic information of PET and the anatomic and functional information of MRI in a single examination.…”

“…We speculated whether histopathological features, including the TSR, influence ADC values and PETrelated parameters in rectal cancer. Therefore, the purpose of this study was to explore possible correlations between the TSR and the different imaging parameters of 18 F-FDG PET/MRI in untreated rectal cancer. We present the following article in accordance with the STROBE reporting checklist (available at https://qims.amegroups.com/article/ view/10.21037/qims-21-938/rc).…”

Predicting Survival in Patients with Pancreatic Cancer by Integrating Bone Marrow FDG Uptake and Radiomic Features of Primary Tumor in PET/CT

“…Because granulopoiesis rather than erythropoiesis strongly contributes to FDG uptake of BM and FDG uptake of BM shows a significant correlation with serum inflammatory markers, including serum C-reactive protein, neutrophil count, NLR, and PLR, the FDG uptake of BM is considered as an imaging parameter for evaluating the degree of systemic inflammatory response [ 15 , 17 , 19 , 28 , 29 ]. Furthermore, a number of studies have demonstrated a significant association between FDG uptake of BM and recurrence-free survival and OS in various malignant diseases including head and neck cancer, lung cancer, breast cancer, gastric cancer, colon cancer, and gynecologic cancer, consistently showing worse survival in patients with high BM FDG uptake [ 15 , 17 , 19 , 27 , 29 , 30 , 31 , 32 , 33 ]. In the present study, BM imaging parameters showed a significant positive association with serum inflammatory markers, and BM SUV was an independent predictor of OS in multivariable analysis after adjusting for age, sex, and TNM stage, indicating that BM SUV could have prognostic significance in patients with pancreatic cancer as well.…”