Hepatic FDG Uptake is not Associated with Hepatic Steatosis but with Visceral Fat Volume in Cancer Screening

Pak, Kyoungjune; Kim, Seong-Jang; Kim, In Joo; Kim, Keunyoung; Kim, Heeyoung; Kim, So Jung

doi:10.1007/s13139-012-0143-y

Cited by 11 publications

(14 citation statements)

References 17 publications

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“…Several previous studies have shown an association between elevated serum liver enzyme levels and the SUVof the liver [12,13]. However, serum liver enzyme levels were not correlated with the liver SUV in this study; serum AST and ALT were not significantly changed during or after chemotherapy and did not show a consistent trend with or without variability of the liver SUV mean .…”

Section: Discussioncontrasting

confidence: 92%

Intra-patient Variability of FDG Standardized Uptake Values in Mediastinal Blood Pool, Liver, and Myocardium during R-CHOP Chemotherapy in Patients with Diffuse Large B-cell Lymphoma

Kim

Lim

et al. 2016

Nucl Med Mol Imaging

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Purpose 18F-fluorodeoxyglucose (FDG) PET/CT is useful for staging and evaluating treatment response in patients with diffuse large B-cell lymphoma (DLBCL). A five-point scale model using the mediastinal blood pool (MBP) and liver as references is a recommended method for interpreting treatment response. We evaluated the variability in standardized uptake values (SUVs) of the MBP, liver, and myocardium during chemotherapy in patients with DLBCL. Methods We analyzed 60 patients with DLBCL who received rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisolone (R-CHOP) treatment and underwent baseline, interim, and final FDG PET/CT scans. The FDG uptakes of lymphoma lesions, MBP, liver, and myocardium were assessed, and changes in the MBP and liver SUV and possible associated factors were evaluated. Results The SUV of the liver did not change significantly during the chemotherapy. However, the SUV mean of MBP showed a significant change though the difference was small (p = 0.019). SUV mean of MBP and liver at baseline and interim scans was significantly lower in patients with advanced Ann Arbor stage on diagnosis. The SUV mean of the MBP and liver was negatively correlated with the volumetric index of lymphoma lesions in baseline scans (r = -0.547, p < 0.001; r = -0.502, p < 0.001). Positive myocardial FDG uptake was more frequently observed in interim and final scans than in the baseline scan, but there was no significant association between the MBP and liver uptake and myocardial uptake. Conclusions The SUV of the liver was not significantly changed during R-CHOP chemotherapy in patients with DLBCL, whereas the MBP SUVof the interim scan decreased slightly. However, the SUV of the reference organs may be affected by tumor burden, and this should be considered when assessing follow-up scans. Although myocardial FDG uptake was more frequently observed after R-CHOP chemotherapy, it did not affect the SUV of the MBP and liver.

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Section: Discussioncontrasting

confidence: 92%

Intra-patient Variability of FDG Standardized Uptake Values in Mediastinal Blood Pool, Liver, and Myocardium during R-CHOP Chemotherapy in Patients with Diffuse Large B-cell Lymphoma

Kim

Lim

et al. 2016

Nucl Med Mol Imaging

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“…There may be a positive correlation between serum liver enzyme levels and SUVs of liver on FDG PET that can affect diagnostic sensitivity of hepatic malignant or infectious lesions on FDG PET (28). Patients with fatty liver disease have higher AST and ALT levels (21). Although patients in the fatty liver group in our study had higher serum enzyme levels, we could not detect any positive relation between SUVs and ALT and AST levels.…”

Section: Discussioncontrasting

confidence: 70%

“…However, there are also other reports in the literature that contradict our findings. Pak et al (21) retrospectively analyzed FDG PET/CT studies of 96 consecutive patients who were screened for cancer and found no significant difference in liver SUVmean and SUVmax between controls and fatty liver group.…”

Section: Discussionmentioning

confidence: 99%

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

Özülker¹,

Özülker²

2019

eamr

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In fluorodeoxyglucose (FDG) positron emission tomography (PET)/computerized tomography (CT) studies, physiological liver FDG uptake has been used as a reference in the evaluation of FDG uptake in pathological processes, even in malignancies. There is an ongoing debate on the effect of liver attenuation and FDG uptake in the liver. We aimed to evaluate the possible effect of fatty infiltration on the standardized uptake value (SUV) of the liver. Methods: A total of 88 patients were included in this study. Subjects were divided into 2 groups by calculating the Hounsfield unit (HU) of the liver from the unenhanced CT part of the PET/CT study and comparing it with that of the spleen. Fatty liver group included 42 patients (26 female, 16 male) with a mean age of 59.6±11.6 years, while control group consisted of 46 patients (22 female, 24 male) with a mean age of 60.2±11 years. The patients with a mean liver attenuation value (in HU) equal and greater than that of spleen were enrolled in the control group, while the patients with a mean liver attenuation value lower than the spleen were included in the fatty liver group. A subset of patients in the fatty liver group with difference in attenuation between the liver and spleen of more than 10 HU (HUS-HUL >10) were evaluated separately. Age, weight, history of diabetes mellitus (DM) and chemotherapy, serum alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels, simultaneous blood glucose levels during PET scan and the elapsed time between FDG injection and the beginning of PET scan were recorded. Results: The average SUVmean and SUVmax values were 2.7±0.7 and 3.6±0.9 in the fatty liver group, 2.8±0.7 and 3.8±1 in the HUS-HUL >10 group and 3.3±0.6 and 4.4±0.9 in the control group, respectively. The average SUVmean and SUVmax values of the fatty liver group and HUS-HUL >10 group were significantly different from the control group (p<0.05). The patients in the fatty liver group had higher ALT (p=0.025) and glucose levels (p=0.001), weight (p=0.001), and DM rate (p=0.002) compared to the control group. Conclusion: Hepatic steatosis causes a statistically significant decrease in SUVmean and SUVmax values in liver. Therefore, we must be careful when using the liver as an internal reference organ

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“…In a retrospective study of 96 consecutive patients who underwent FDG-PET/CT for cancer screening, Pak et al reported that hepatic FDG uptake was strongly correlated with VAT volume [37]. In light of these reported results, our observed results may alternatively be related indirectly to the effects of tobacco use upon VAT volume.…”

Section: Discussionmentioning

confidence: 52%

A Study of the Feasibility of FDG-PET/CT to Systematically Detect and Quantify Differential Metabolic Effects of Chronic Tobacco Use in Organs of the Whole Body—A Prospective Pilot Study

et al. 2017

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Objective The aim of this study was to assess the feasibility of 18F-fluorodeoxyglucose (FDG)-positron emission tomography/computed tomography (PET/CT) to systematically detect and quantify differential effects of chronic tobacco use in organs of the whole body. Methods 20 healthy male subjects (10 non-smokers and 10 chronic heavy smokers) were enrolled. Subjects underwent whole-body FDG-PET/CT, diagnostic unenhanced chest CT, mini-mental state examination (MMSE), urine testing for oxidative stress and serum testing. Organs of interest (thyroid, skin, skeletal muscle, aorta, heart, lung, adipose tissue, liver, spleen, brain, lumbar spinal bone marrow, and testis) were analyzed from FDG-PET/CT images to determine their metabolic activities using standardized uptake value (SUV) or metabolic volumetric product (MVP). Measurements were compared between subject groups using 2-sample t-tests or Wilcoxon rank-sum tests as determined by tests for normality. Correlational analyses were also performed. Results FDG-PET/CT revealed significantly decreased metabolic activity of lumbar spinal bone marrow (MVPmean 29.8±9.7 cc vs. 40.8±11.6 cc, p=0.03) and liver (SUVmean 1.8±0.2 vs. 2.0±0.2, p=0.049), and increased metabolic activity of visceral adipose tissue (VAT) (SUVmean 0.35±0.10 vs. 0.26±0.06, p=0.02) in chronic smokers compared to non-smokers. Normalized VAT volume was also significantly decreased (p=0.04) in chronic smokers. There were no statistically significant differences in the metabolic activity of other assessed organs. Conclusions Subclinical organ effects of chronic tobacco use are detectable and quantifiable on FDG-PET/CT. FDG-PET/CT may therefore play a major role in the study of systemic toxic effects of tobacco use in organs of the whole body for clinical or research purposes.

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Hepatic FDG Uptake is not Associated with Hepatic Steatosis but with Visceral Fat Volume in Cancer Screening

Abstract: Purpose We aimed to evaluate the relation between visceral fat volume and fluorodeoxyglucose (FDG) uptake of the liver measured by maximum or mean standardized uptake value.

Cited by 11 publications

References 17 publications

Intra-patient Variability of FDG Standardized Uptake Values in Mediastinal Blood Pool, Liver, and Myocardium during R-CHOP Chemotherapy in Patients with Diffuse Large B-cell Lymphoma

Intra-patient Variability of FDG Standardized Uptake Values in Mediastinal Blood Pool, Liver, and Myocardium during R-CHOP Chemotherapy in Patients with Diffuse Large B-cell Lymphoma

Assessment of the Effect of Fatty Infiltration on Hepatic FDG Uptake

A Study of the Feasibility of FDG-PET/CT to Systematically Detect and Quantify Differential Metabolic Effects of Chronic Tobacco Use in Organs of the Whole Body—A Prospective Pilot Study

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