Whole-body metabolic tumour volume of 18F-FDG PET/CT improves the prediction of prognosis in small cell lung cancer

Oh, Jong-Ryool; Seo, Ji-Hyoung; Chong, Ari; Min, Jung‐Joon; Song, Ho‐Chun; Kim, Young‐Chul; Bom, Hee‐Seung

doi:10.1007/s00259-011-2059-7

Cited by 99 publications

(131 citation statements)

References 24 publications

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“…The active utilization of glucose by tumor cells constitutes the basis for 18 FDG-PET imaging for cancer diagnosis, and positive FDG-PET signals in the tumor sites after treatment predict poor prognosis. [21][22][23][24] Because CSCs are resistant to conventional chemotherapeutic agents, it is possible that the tumor cells in the residual lesions after chemotherapy might represent CSCs with elevated glycolytic activity. This prompted us to compare glucose metabolic activity in SP and non-SP cells.…”

Section: Resultsmentioning

confidence: 99%

Metabolic regulation of cancer cell side population by glucose through activation of the Akt pathway

et al. 2013

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Side population (SP) cells within tumors are a small fraction of cancer cells with stem-like properties that can be identified by flow cytometry analysis based on their high ability to export certain compounds such as Hoechst 33342 and chemotherapeutic agents. The existence of stem-like SP cells in tumors is considered as a key factor contributing to drug resistance, and presents a major challenge in cancer treatment. Although it has been recognized for some time that tumor tissue niches may significantly affect cancer stem cells (CSCs), the role of key nutrients such as glucose in the microenvironment in affecting stem-like cancer cells and their metabolism largely remains elusive. Here we report that SP cells isolated from human cancer cells exhibit higher glycolytic activity compared to non-SP cells. Glucose in the culture environment exerts a profound effect on SP cells as evidenced by its ability to induce a significant increase in the percentage of SP cells in the overall cancer cell population, and glucose starvation causes a rapid depletion of SP cells. Mechanistically, glucose upregulates the SP fraction through ATP-mediated suppression of AMPK and activation of the Akt pathway, leading to elevated expression of the ATP-dependent efflux pump ABCG2. Importantly, inhibition of glycolysis by 3-BrOP significantly reduces SP cells in vitro and impairs their ability to form tumors in vivo. Our data suggest that glucose is an essential regulator of SP cells mediated by the Akt pathway, and targeting glycolysis may eliminate the drug-resistant SP cells with potentially significant benefits in cancer treatment. Accumulating evidence suggests that tumors of various tissue origins, including the brain, breast, and lung, contain a small subpopulation of special cells with stem-like properties, often referred to as cancer stem cells (CSCs) or tumor-initiating cells. [1][2][3][4][5][6][7] In addition to the ability of CSCs to self-renew and initiate tumor formation, one important biochemical feature of CSCs is their ability to export certain toxic compounds and resistance to many chemotherapeutic agents due in part to their high expression of ATP-dependent efflux pump ABCG2, their increased DNA repair capacity, and activation of survival pathways. [8][9][10] The increase in expression of ABCG2 also confers CSCs the ability to effectively export the DNA-binding dye Hoechst 33342 out of the cells, leading to a low retention of the fluorescent signal in these cells, which appear at the low-left corner in flow cytometry analysis and thus are known as 'side population' or SP cells. 2,11 As SP cells can be readily identified by flow cytometry in a quantitative manner, the measurement of SP cells has been widely used as a quantitative assay for the relative number (%) of stem-like cancer cells in the bulk of the overall cancer cell population. Importantly, as this assay is functionally based on the ability of SP cells to export Hoechst 33342 and certain toxic compounds, it is also a quantitative analysis of the subpopulatio...

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Section: Resultsmentioning

confidence: 99%

Metabolic regulation of cancer cell side population by glucose through activation of the Akt pathway

et al. 2013

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“…Standardized uptake value (SUV)-based PET parameter can predict therapeutic outcome and overall survival in many types of malignancies [6][7][8][9][10][11][12]. Recently, metabolic tumor volume (MTV) and total lesion glycolysis (TLG) have been reported as additional diagnostic and prognostic imaging biomarkers for maximum SUV (SUVmax) [13][14][15].…”

Section: Introductionmentioning

confidence: 99%

Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

Yoo

Kim

Chong

et al. 2012

Nucl Med Mol Imaging

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Purpose This study aimed to further stratify prognostic factors in patients with stage IV non-small cell lung cancer (NSCLC) by measuring their metabolic tumor volume (MTV) using F-18 fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT). Materials and MethodsThe subjects of this retrospective study were 57 patients with stage IV NSCLC. MTV, total lesion glycolysis (TLG), and maximum standardized uptake value (SUVmax) were measured on F-18 FDG PET/CT in both the primary lung lesion as well as metastatic lesions in torso. Optimal cutoff values of PET parameters were measured by receiver operating characteristic (ROC) curve analysis. Kaplan-Meier survival curves were used for evaluation of progression-free survival (PFS). The univariate and multivariate Cox proportional hazards models were used to select the significant prognostic factors. Results Univariate analysis showed that both MTV and TLG of primary lung lesion (MTV-lung and TLG-lung) were significant factors for prediction of PFS (P<0.001, P00.038, respectively). Patients showing lower values of MTV-lung and TLG-lung than the cutoff values had significantly longer mean PFS than those with higher values. Hazard ratios (95 % confidence interval) of MTV-lung and

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“…Evrelemede FDG PET/BT görüntülemenin kullanılması KHAK evresinde ve tedavi planında %11-%37 oranında değişikliğe neden olmaktadır (37,38,39). Akciğer kanserinde genel olarak gözlenen SUV maks ve metabolik tümör volümü (MTV) değerleri ile sağkalım arasındaki ilişkiler KHAK için de geçerlidir (39,40,41).…”

Section: Küçük Hücreli Akciğer Kanserinde Evrelemeunclassified

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

Akdemir¹,

Aydos²

2018

Nts

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GirişAkciğer kanseri, en sık görülen kanser türlerinden biri olup, tedavi olanaklarındaki iyileşmelere rağmen kansere bağlı ölüm nedenleri arasında birinci sırada yer alır (1). Tüm akciğer kanserlerinin yaklaşık %85'ini küçük hücreli dışı akciğer kanseri (KHDAK), kalan kısmını da küçük hücreli akciğer kanseri (KHAK) oluşturur (2).KHAK hastalarının çoğunda tanı anında uzak metastaz bulunması ve bu hastaların cerrahi tedavi olasılıklarının düşük olması; buna karşılık KHDAK hastalarında cerrahi tedavi olasılığının daha yüksek olması nedeniyle bu sınıflama özellikle tedavi yaklaşımı bakımından önem taşır. Akciğer kanseri tanısı alan hastalarda uygun tedavi seçeneğini belirlemek ve hasta prognozunu Flor-18 ile işaretli florodeoksiglikoz (FDG) ile yapılan pozitron emisyon tomografisi/bilgisayarlı tomografi (PET/ BT) akciğerde kuşkulu parankimal nodülü olan veya akciğer kanseri tanısı alan hastaların klinik yönetiminde kullanılan güçlü bir tanı aracıdır. Bu yazıda FDG PET/BT görüntülemenin kuşkulu akciğer nodüllerinin değerlendirilmesinde ve yeni tanı akciğer kanserinde evrelemesindeki yerinden, sayısal PET değişkenlerinin hasta prognozu ile ilişkisinden, hibrid PET/manyetik rezonans sistemi gibi teknik gelişmelerden ve akciğer kanserinin patofizyolojisi ile ilişkili FDG dışındaki diğer PET radyofarmasötiklerinin kullanımından bahsedilmektedir. Anahtar Kelimeler: Akciğer kanseri, küçük hücreli-dışı akciğer kanseri, küçük hücreli akciğer kanseri, FDG, PET/BT görüntüleme Positron emission tomography/computed tomography (PET/ CT) using fluorine-18 labelled fluorodeoxyglucose (FDG) is a powerful tool for managing patients with suspected lung nodules and lung cancer. In this review, we discuss the utility of FDG PET/CT imaging in evaluation of suspected pulmonary nodules and initial staging of patients with newly diagnosed lung cancer, prognostic value of quantitative PET parameters, technical developments in PET imaging such as hybrid PET/ magnetic resonance systems, and the use of other PET radiopharmaceuticals related to lung cancer pathophysiology.

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Whole-body metabolic tumour volume of 18F-FDG PET/CT improves the prediction of prognosis in small cell lung cancer

Abstract: WBMTV is an independent predictor for progression and death in patients with SCLC. Incorporation of WBMTV with TNM staging can provide a more detailed prediction of prognosis than WBMTV with conventional staging as well as tumour staging alone.

Cited by 99 publications

References 24 publications

Metabolic regulation of cancer cell side population by glucose through activation of the Akt pathway

Metabolic regulation of cancer cell side population by glucose through activation of the Akt pathway

Metabolic Tumor Volume Measured by F-18 FDG PET/CT can Further Stratify the Prognosis of Patients with Stage IV Non-Small Cell Lung Cancer

Role of Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Imaging in Diagnosis and Staging of Lung Cancer

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