Inverse Correlation Between Tumor Perfusion and Glucose Uptake in Human Head and Neck Tumors

Hirasawa, Satoshi; Tsushima, Yoshito; Takei, Hiroyuki; Hirasawa, Hiromi; Taketomi-Takahashi, Ayako; Takano, Akie; Oriuchi, Noboru; Endo, Keigo

doi:10.1016/j.acra.2006.12.017

Cited by 28 publications

(36 citation statements)

References 18 publications

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“…As a consequence, many tumors are characterized by a functional coupling of blood flow and metabolism as evidenced by parallel increases in blood flow and tumor glucose metabolism as reported for numerous tumors, including those of the breast (27,30) and lung (31). In contrast, some tumors appear to display considerable variance between perfusion and metabolism with evidence of an uncoupling of blood flow from metabolism in specific cases (32), as recently reported for some head and neck cancers (33) and certain liver and metastatic colon cancers (34). Hence, in these cases it is important to be able to monitor both blood flow and metabolism to aid in the assessment of the type of cancer, the staging, or the planning of treatment regimens before therapy.…”

Section: Clinical Utility Of Perfusion Images For Tumor Imagingmentioning

confidence: 58%

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow

Mullani¹,

Herbst²,

O’Neil³

et al. 2008

J Nucl Med

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PET molecular imaging of 15 O-labeled water is the gold standard for measuring blood flow in humans. However, this requires an on-site cyclotron to produce the short-lived 15 O tracer, which is cost-prohibitive for most clinical PET centers. The purpose of this study was to determine if the early uptake of 18 F-FDG could be used to measure regional blood flow in tumors in the absence of 15 O-water. Methods: PET scans were obtained in patients being evaluated for tumor perfusion and glucose metabolism in a phase I dose-escalating protocol for endostatin, a novel antiangiogenic agent. A 2-min perfusion scan was performed with a bolus injection of 2,220 MBq (60 mCi) of 15 O-water, which was followed by a 370-MBq (10 mCi) dose of 18 F-FDG. Four sequential scans of 18 F-FDG uptake were acquired, consisting of an early 2-min uptake scan-or first-pass scan-and 3 sequential 15-min late 18 F-FDG uptake scans. Regions of interest (ROIs) were drawn on 2 or more tumor sites and on back muscle, as a control ROI, for each patient. Arterial blood concentration was derived from the PET scans by drawing an ROI over a large artery in the field of view. Blood flow was computed with a simple 1-compartment blood flow model using the first 2 min of data after injection. Results: Blood flow estimated from the early uptake of 18 F-FDG was linearly correlated with 15 O-measured blood flow, with an intercept of 0.01, a slope of 0.86, and an R 2 regression coefficient of 0.74 (r 5 0.86). The 18 F-FDG tumor extraction fraction relative to 15 O-water averaged 0.86. A preliminary case study of a patient with prostate cancer confirms the utility of the first-pass 18 F-FDG blood flow analysis in tumor diagnosis. Conclusion: These results suggest that the first-pass uptake of 18 F-FDG may provide an estimate of perfusion in a tumor within the limitations of incomplete extraction of 18 F-FDG compared with 15 O-water.

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Section: Clinical Utility Of Perfusion Images For Tumor Imagingmentioning

confidence: 58%

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow

Mullani¹,

Herbst²,

O’Neil³

et al. 2008

J Nucl Med

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“…10,25 It is notable that Mankoff et al 25 showed a positive correlation between SUV and BF measured with 15 H 2 O-PET (considered the criterion standard in determination of BF) in patients with advanced breast cancer. Other PCT studies 8,9 in liver and head and neck cancers have shown that a negative correlation between SUV and tissue perfusion may also exist. In these cases, it has been postulated that the increasing neoangiogenesis of the tumor results in inadequate oxygen supply, which subsequently leads to an uncoupling of glucose uptake and BF.…”

Section: Discussionmentioning

confidence: 96%

“…There is only very limited evidence in the literature with conflicting results for various organs. [8][9][10] Furthermore, in these reports, the functional studies were separately acquired (and subsequently fused). The PET protocol and the postprocessing of the PCT varied between the studies.…”

mentioning

confidence: 99%

Whole-Tumor Perfusion CT Parameters and Glucose Metabolism Measurements in Head and Neck Squamous Cell Carcinomas: A Pilot Study Using Combined Positron-Emission Tomography/CT Imaging

Bisdas

Spicer²,

Rumboldt³

2008

AJNR Am J Neuroradiol

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BACKGROUND AND PURPOSE:Previous (separately performed) perfusion CT (PCT) and PET studies have been inconclusive regarding the correlation of functional tumor characteristics. The purpose of this study was to perform dual assessment of head and neck squamous cell carcinomas (SCCAs) to examine the relationship between perfusion measurements derived from PCT and glucose standardized uptake values (SUV).

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“…However, coupling and significant correlation might depend on the tumour entity and glycolytic status of the tumour. Hirasawa and co-workers found in a small patient population with suspected head and neck tumours that BF and SUV measurement were inversely correlated [15]. They concluded that this might be attributed to anaerobic glycolysis which is contradictory with the results mentioned above in head and neck cancers and other tumour entities.…”

Section: Correlation Of Pet and Ctp Valuesmentioning

confidence: 85%

“…Currently there is only very limited information about the potential relation between FDG parameters (SUVmax and SUVmean) and CTP parameters in head and neck cancers [14,15]. Additionally, there is no information about the potential correlation between CTP values and additional PET parameters (e.g.…”

Section: Introductionmentioning

confidence: 99%

Combined PET/CT-perfusion in patients with head and neck cancers

et al. 2012

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Objectives Computed tomography perfusion (CTP) can provide information about angiogenesis and blood-flow characteristics in tumours.[18F]Fluoro-2-deoxy-D-glucosepositron emission tomography/computed tomography (FDG-PET/CT) is one of the major oncological imaging techniques which provides information about viability of the tumour cell and partly also about its aggressiveness. The aim of the study was to investigate the relationship between FDG and CTP data in patients with head and neck cancers.Materials and methods Forty-one patients with a clinically suspected head and neck cancer were prospectively included. All patients underwent a combined PET/CT with an integrated CTP examination in the area of the head and neck tumour. CTP data (BF, BVand MTT) and PET data (SUVmax, SUVmean, TLG, PETvol) were compared between tumours and (1) healthy contralateral tissue, (2) inflammatory lesions, (3) metastatic lymph nodes, and CTP data and PET data were correlated in tumours. Results Thirty-five patients had a head and neck cancer. All CTP data were statistically different between tumours, inflammatory lesions, healthy tissue and metastatic lymph nodes; PET/CT data were in part significantly different. CTP and PET parameters were not significantly correlated. Conclusion CTP and PET parameters were not significantly correlated; thus, the additional CTP values provide additional insights into tumour behaviour and their glycolytic status. Key Points • Computed tomography perfusion (CTP) can be performed in combined positron emission tomography (PET)/CT.• CTP in addition to PET provides additional insights into tumour behaviour.• CTP can possibly differentiate between head and neck tumours and inflammatory lesions.

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Inverse Correlation Between Tumor Perfusion and Glucose Uptake in Human Head and Neck Tumors

Cited by 28 publications

References 18 publications

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow

Whole-Tumor Perfusion CT Parameters and Glucose Metabolism Measurements in Head and Neck Squamous Cell Carcinomas: A Pilot Study Using Combined Positron-Emission Tomography/CT Imaging

Combined PET/CT-perfusion in patients with head and neck cancers

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Inverse Correlation Between Tumor Perfusion and Glucose Uptake in Human Head and Neck Tumors

Cited by 28 publications

References 18 publications

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass 18F-FDG Uptake: A Comparison with 15O-Labeled Water-Measured Blood Flow

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass 18F-FDG Uptake: A Comparison with 15O-Labeled Water-Measured Blood Flow

Whole-Tumor Perfusion CT Parameters and Glucose Metabolism Measurements in Head and Neck Squamous Cell Carcinomas: A Pilot Study Using Combined Positron-Emission Tomography/CT Imaging

Combined PET/CT-perfusion in patients with head and neck cancers

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Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow

Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass ¹⁸F-FDG Uptake: A Comparison with ¹⁵O-Labeled Water-Measured Blood Flow