18F-FDG uptake of visceral adipose tissue on preoperative PET/CT as a predictive marker for breast cancer recurrence

Abstract

Glucose utilization by visceral adipose tissue (VAT) reflects inflammatory activity, which also promotes tumor growth and carcinogenesis. The effect of metabolically active VAT on survival outcomes in breast cancer is unknown. We investigated survival outcomes in patients with breast cancer based on the standardized uptake value (SUV) of VAT (SUVmean-VAT) using 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT). A total of 148 patients with breast cancer were divided into high- and low groups according to their SUVmean-VAT and SUVmax-tumor. Clinical characteristics and survival outcomes were compared between the groups. High SUVmean-VAT was associated with poor recurrence-free survival (RFS; hazard ratio [HR], 2.754; 95% confidence interval [CI], 1.090–6.958, p = 0.032) and distant metastasis-free survival (DMFS; HR, 3.500; 95% CI, 1.224–10.01, p = 0.019). Multivariate analysis showed that high SUVmean-VAT was a significant factor for poor RFS and poor DMFS (p = 0.023 and 0.039, respectively). High SUVmax-tumor was significantly associated with short RFS (p = 0.0388). Tumors with a high SUV tended to have a short DMFS, although the difference was not significant (p = 0.0718). Our findings showed that upregulated glucose metabolism in the VAT measured using 18F-FDG PET/CT may be a prognostic biomarker for adverse outcomes in breast cancer.

Synthetic 18F labeled biomolecules that are selective and promising for PET imaging: major advances and applications

“…✓ Its uptake by visceral adipose tissue (VAT) helps in imaging inflammatory activities and tumor growth. 41…”

Prognostic Impact of Visceral Adipose Tissue Imaging Parameters in Patients with Cholangiocarcinoma after Surgical Resection

“…However, the quantitative parameters of adipose tissue, such as BMI and areas of SAT and VAT as measured on imaging studies, are inadequate for directly reflecting inflammatory changes in adipose tissue. Therefore, two imaging parameters, mean computed tomography (CT) attenuation on unenhanced CT images and mean 2-deoxy-2-[ 18 F]fluoro-D-glucose (FDG) uptake on positron emission tomography (PET) images, have been proposed to estimate qualitative changes in adipose tissue in imaging studies [12][13][14]. In previous studies, these two imaging parameters measured from SAT and VAT were shown to be correlated with the degree of inflammatory changes in adipose tissue, as well as significantly associated with survival in patients with diverse malignant diseases, including gastric cancer, hepatocellular carcinoma, and colorectal cancer [12,[14][15][16][17].…”