Glucose Metabolism and Its Complicated Relationship with Tumor Growth and Perfusion in Head and Neck Squamous Cell Carcinoma

Abstract

ObjectiveTo determine the relationship between tumor glucose metabolism and tumor blood flow (TBF) in head and neck squamous cell carcinoma (HNSCC).MethodsWe retrospectively analyzed 57 HNSCC patients. Tumor glucose metabolism was assessed by maximum and mean standardized uptake values (SUVmax and SUVmean) obtained by 18F-fluorodeoxyglucose positron-emission tomography. TBF values were obtained by arterial spin labeling with 3-tesla MRI. The correlations between both SUVs and TBF were assessed in the total series and among patients divided by T-stage (T1–T3 and T4 groups) and tumor location (pharynx/oral cavity and sinonasal cavity groups). Pearson’s correlation coefficients were calculated for significant correlations.ResultsSignificant correlations were detected: a negative correlation in the advanced T-stage group (TBF and SUV max: r, −0.61, SUVmean: r, −0.62), a positive correlation in the non-advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, 0.70, SUVmean: r, 0.73), a negative correlation in the advanced T-stage pharynx/oral cavity group (TBF and SUVmax: r, −0.62, SUVmean: r, −0.65), and a negative correlation in the advanced T-stage sinonasal cavity group (TBF and SUVmax: r, −0.61, SUVmean: r, −0.65).ConclusionSignificant correlations between glucose uptake and TBF in HNSCC were revealed by the division of T-stage and tumor location.

Tumor Blood Flow Is a Predictor of Radiotherapy Response in Patients With Nasopharyngeal Carcinoma

“…Insufficient blood supply leads to relatively low TBF, whereas an aggressive tumor itself demands a high glucose uptake in anaerobic glycolysis. The uncoupling of blood supply and tumor growth may result in low oxygenation of tumor tissue, i.e., tumor hypoxia, which might lead to resistance to radiotherapy (26). Our study showed no correlation between the SUVmax of primary tumors or metastasis lymph nodes and radiation response.…”

“…Komar G previously concluded that there was no correlation between SUV and TBF value in HNSCC patients (25), our study came to a similar conclusion. Fujima (26) showed significant correlations between SUV and TBF in HNSCC by different T-stage and tumor locations, i.e., positive correlation in the early T-stage pharynx/oral carcinoma, negative correlation in the advanced T-stage in both the pharynx/oral and sinonasal carcinoma, and no correlation in the overall patient analysis. The conflicting result may be due to several factors such as tumor size, tumor proliferation activity, or the mismatch of angiogenesis and tumor proliferation.…”

Semi-quantitative analysis of pre-treatment morphological and intratumoral characteristics using 18F-fluorodeoxyglucose positron-emission tomography as predictors of treatment outcome in nasal and paranasal squamous cell carcinoma

“…FDG-PET/CT data provide rough anatomical information about the tumor revealed by the lesion's elevated FDG uptake. Moreover, the tumor margin can be easily set using the threshold of FDG uptake from FDG-PET/CT imaging, allowing objective quantification of the whole tumor area (13). From this morphological data, several parameters related to the tumor morphological shape can be calculated.…”

Integrating quantitative morphological and intratumoural textural characteristics in FDG-PET for the prediction of prognosis in pharynx squamous cell carcinoma patients

“…We measured the SUV value for each tumour by determining the automated ROI using an isocontour threshold method. A threshold SUV value of 2.5 was set for the tumour ROI delineation to exclude the central necrosis or nearly normal tissue uptake [16]. If a tumour extended to two or more slices, all slices that showed tumour FDG uptake were analyzed.…”