Correlation of ¹⁸F-FDG/PET SUV_max, SUV_mean, MTV, and TLG with HIF-1α in Patients with Colorectal Cancer

Abstract

Objectives: Post-hypoxia hypoxia-inducible factor (HIF)-1α activation plays a vital role in colorectal cancer (CRC) angiogenesis. Although glucose metabolism is induced in some cancer types via HIF-1α, the prognostic significance of HIF-1α in CRC and its correlation with 18 fluorinefluorodeoxyglucose ( 18 F-FDG) uptake in positron emission tomography (PET) remain controversial. This study aims to investigate the association between 18 F-FDG/PET parameters and HIF-1α expression in CRC. Methods: Thirty-six histopathologically confirmed patients with CRC who had 18 F-FDG/PET scans before surgery were enrolled in the study. The correlations between the maximum standardized uptake value (SUV max ), SUV mean , metabolic tumor volume (MTV), total lesion glycolysis, HIF-1α overexpression, and histopathological features were evaluated. Results: The tumor location, tumor diameter, perineural invasion, lymphovascular invasion, T and N stage were not significantly correlated with HIF-1α overexpression. In contrast, the tumor differentiation was negatively correlated with HIF-1α expression (r=-0.332, p=0.048). None of the 18 F-FDG/PET parameters was significantly correlated with HIF-1α overexpression. A significant relationship was found between tumor differentiation, tumor necrosis percentage, and MTV (p=0.030, p=0.020). Conclusion: The expected association between HIF-1α overexpression and 18 F-FDG/PET parameters was not found in this study. However, there was a relationship between MTV, tumor differentiation, and tumor necrosis percentage. Hence, further studies are required to predict the pathological and prognostic courses of CRC using a diagnostic 18 F-FDG/PET evaluation.

Prognostic significance of 18F-Fluorodeoxyglucose positron-emission tomography parameters in patients with biliary tract cancers: a meta-analysis

“…These results suggested that SUVmax, as a prognostic factor, could reflect cancer immune microenvironment. Interestingly, SUVmax was also associated with tumor tissue hypoxia and angiogenesis, contributing to cancer progression [ 40 , 41 ].…”

“…MTV and TLG, which are a combination of volumetric and metabolic parameters, may be utilized in metabolic analyses of radiotracer activity, reflecting both properties of the tumor tissues. These parameters were also related to angiogenesis [ 41 ] and cancer immunity [ 42 ]. Taken these considerations, the above parameters in 18F PDF PET were associated to glucose intake, which regards cancer metabolism activity, tumor microenvironment, and immunity.…”

18F‑fluorodeoxyglucose positron emission tomography predicts recurrence and histological grade of extrahepatic bile duct cancer

“…The relationship between HIF-1α and FDG-PET/CT parameters is controversial. Kaymak et al (22) revealed no significant association between HIF-1α and SUVmax in colorectal carcinoma probably because of the heterogeneity of the oxygen situation within the tumor.…”