Glucose metabolism correlated with cellular proliferation in diffuse large B-cell lymphoma

Abstract

Standardized uptake value (SUV) is a marker of tumor glucose metabolism detected by [18F]-fluorodeoxyglucose positron emission tomography/computed tomography ((18)F-FDG-PET/CT). The maximum SUV of the whole-body (BmSUV(max)) reflects the tumor aggressiveness in non-Hodgkin lymphoma. To evaluate the correlation between SUV(max) at biopsy site (BxSUV(max)) and proliferation potential of tumor cells in untreated diffuse large B-cell lymphoma (DLBCL), fifteen pre-therapy PET/CT scans in patients with histologically proven DLBCL were retrospectively analyzed together with Ki-67 proliferation index. The BmSUV(max) and BxSUV(max) were evaluated from the fused PET/CT images. Ki-67 proliferation index was measured in the biopsy specimens using an immunohistochemical technique in archival paraffin-embedded sections. The BmSUV(max) was significantly higher than the BxSUV(max) (mean 19.6 vs.16.6, p < 0.01). The BxSUV(max) correlated with the Ki-67 proliferation index (r = 0.7, p < 0.01), but no correlation was detected between the BmSUV(max) and the Ki-67 proliferation index. The results indicate that tumor proliferation potential might be predicted in vivo by FDG-PET/CT images. Thus, PET/CT is useful to guide biopsy by selecting sites with the BmSUV(max) when clinically appropriate.

Predictors of Local Recurrence After Rituximab-Based Chemotherapy Alone in Stage III and IV Diffuse Large B-Cell Lymphoma: Guiding Decisions for Consolidative Radiation

“…SUVmax offers a quantitative representation of glucose utilization. This can be a proxy for proliferative rate in DLBCL in vivo 23]. Our study is the first to identify SUVmax ≥15 as a potential predictor of LR in patients with non-bulky disease.…”

The impact of baseline and interim PET/CT parameters on clinical outcome in patients with diffuse large B cell lymphoma

“…Previous studies suggested the association between SUV max and tumor aggressiveness [21][22][23]. And recently, the fact that proliferation potential of tumor cells measured by Ki-67 stain positively correlated with SUV max has been reported [24][25][26][27][28]. However, the measurement of SUV max has confined to the detection of the most obvious metabolic activity of the tumor at single site, but not the overall tumor activity.…”

Dual-time-point F-18 FDG PET/CT imaging for differentiating the lymph nodes between malignant lymphoma and benign lesions

“…The F-18 FDG uptake by lymphoma is probably associated with Glut1 expression [25, 26] and Ki-67 values [27, 28]. In many malignant tumors, scan start times of 45–60 min have been reported to cause significant underestimation of the true SUVs, because SUVs do not reach maximum levels until several hours after F-18 FDG injection [2, 23, 29].…”

“…Consequently, we performed ROC analysis without comparing each histological subtype. However, some authors have reported that the SUVmax tended to be lower in Hodgkin’s lymphoma and T-cell lymph nodes than in B-cell lymphoma, with differences observed in the early SUVmax [28]. Examination of a larger number of patients in a prospective study could help in evaluating the role of dual-time-point PET/CT scans in diagnosis of lymphoma.…”