The role of 18F-fluorodeoxyglucose uptake of bone marrow on PET/CT in predicting clinical outcomes in non-small cell lung cancer patients treated with chemoradiotherapy

Abstract

• Bone marrow FDG uptake is correlated with serum inflammatory markers. • Bone marrow FDG uptake is an independent prognostic factor for progression-free survival. • Bone marrow FDG uptake can provide information on predicting lung cancer progression.

Clinical implication of FDG uptake of bone marrow on PET/CT in gastric cancer patients with surgical resection

“…The results of the present study also showed significant correlation of BM SUV and BLR with NLR and PLR. BLR showed greater statistical significance and higher correlation coefficients with serum inflammatory markers compared to BM SUV, in agreement with the results of previous studies showing that BLR could reduce the inter-individual variation of FDG uptake of BM[17,18,25]. In addition, patients with advanced gastric cancer, recurrence, and positive FDG uptake of primary cancer had higher FDG uptake than those with early gastric cancer, no recurrence, and negative FDG uptake, respectively, indicating that gastric cancer patients with advanced stage and aggressive features might have higher degrees of systemic inflammatory response.…”

“…Results of our study demonstrated that BLR was an independent prognostic factor for predicting both RFS and OS, along with other known prognostic clinical factors including T4 stage, lymph node metastasis, tumor involvement of resection margin, and hemoglobin level[13,26,32]. It has been shown that FDG uptake BM has significant association with survival in patients with head and neck cancer and lung cancer[17,22,25,33]. The present study also corroborates this association in patients with gastric cancer.…”

“…In contrast, previous studies have revealed that patients with various inflammatory diseases and cancers could have increased FDG uptake of BM and that FDG uptake of BM is significantly associated with white blood cell and neutrophil counts and CRP level[18,23]. Furthermore, in patients with lung cancer, FDG uptake of BM is significantly higher than that in those with benign lung nodules and is associated with white blood cell counts, NLR, PLR, and serum levels of albumin and CRP[17,24,25]. These results suggest that FDG uptake of BM can reflect the degree of BM activation due to systemic inflammatory response to malignancy[17,18,25].…”

“…Furthermore, in patients with lung cancer, FDG uptake of BM is significantly higher than that in those with benign lung nodules and is associated with white blood cell counts, NLR, PLR, and serum levels of albumin and CRP[17,24,25]. These results suggest that FDG uptake of BM can reflect the degree of BM activation due to systemic inflammatory response to malignancy[17,18,25]. The results of the present study also showed significant correlation of BM SUV and BLR with NLR and PLR.…”

“…Previous studies have demonstrated controversial results for the relationship between FDG uptake of BM and hemoglobin level in various kinds of malignancy[17,18,22,23,25]. In gastric cancer, significant portion of patients had anemia and hemoglobin level is a significant prognostic factor for survival[26].…”