Prognostic Value of CT-Attenuation and 18F-Fluorodeoxyglucose Uptake of Periprostatic Adipose Tissue in Patients with Prostate Cancer

Abstract

This study aimed to assess the prognostic value of computed tomography (CT)-attenuation and 18F-fluorodeoxyglucose (FDG) uptake of periprostatic adipose tissue (PPAT) for predicting disease progression-free survival (DPFS) in patients with prostate cancer. Seventy-seven patients with prostate cancer who underwent staging FDG positron emission tomography (PET)/CT were retrospectively reviewed. CT-attenuation (HU) and FDG uptake (SUV) of PPAT were measured from the PET/CT images. The relationships between these PPAT parameters and clinical factors were assessed, and a Cox proportional hazard regression test was performed to evaluate the prognostic significance of PPAT HU and SUV. PPAT HU and SUV showed significant positive correlations with tumor stage and serum prostate-specific antigen level (PSA) (p < 0.05). Patients with high PPAT HU and SUV had significantly worse DPFS than those with low PPAT HU and SUV (p < 0.05). In multivariate analysis, PPAT SUV was a significant predictor of DPFS after adjusting for tumor stage, serum PSA, and tumor SUV (p = 0.003; hazard ratio, 1.50; 95% confidence interval, 1.15–1.96). CT-attenuation and FDG uptake of PPAT showed significant association with disease progression in patients with prostate cancer. These imaging findings may be evidence of the role of PPAT in prostate cancer progression.

Predicting the Recurrence of Gastric Cancer Using the Textural Features of Perigastric Adipose Tissue on [18F]FDG PET/CT

“…In terms of metabolic alterations, adipocytes lose their intracellular lipid content and provide exogenous fatty acids to cancer cells [ 7 ]. Since these morphological and functional modifications of adipocytes and inflammatory responses in the AT would bring qualitative changes in AT, a number of studies have tried to investigate whether the parameters of AT on diagnostic imaging examinations could represent these changes and could therefore be used as predictive factors for cancer progression [ 16 , 18 , 23 , 25 ]. On [ 18 F]FDG PET/CT, the mean SUV of visceral AT was proposed to be an imaging parameter that could reflect these qualitative changes in AT [ 16 , 18 , 23 , 26 , 27 ].…”

“…In addition to detecting malignant lesions, since [ 18 F]FDG PET/CT can be used to evaluate glucose metabolism in an organ, several studies have demonstrated the clinical use of [ 18 F]FDG PET/CT in estimating the host response to cancers [ 15 , 16 ]. In previous studies, PET imaging parameters of AT were significantly associated with the presence of lymph node metastases and clinical outcomes in diverse cancers, suggesting that PET imaging parameters of AT could be used as surrogate markers of inflammatory response in AT [ 16 , 17 , 18 ]. Since gastric cancer cells also have a substantial interrelationship with peritumoral AT, [ 18 F]FDG PET imaging features of peritumoral AT could reflect this interaction and have a significant association with cancer progression in patients with gastric cancer.…”

Clinical Significance of Peritumoral Adipose Tissue PET/CT Imaging Features for Predicting Axillary Lymph Node Metastasis in Patients with Breast Cancer

“…In the previous studies, FDG uptake of AT in the PET/CT images was used as an imaging parameter reflecting the qualitative changes of the AT microenvironment induced by interaction between cancer cells and adipocytes [ 19 , 31 ]. In patients with pancreatic cancer, gastric cancer, and prostate cancer, the mean FDG uptake of peritumoral AT showed a significant positive relationship with tumor aggressiveness and was an independent predictor of survival [ 18 , 19 , 20 ]. The results of this study demonstrated significant differences in textural features of FDG PET/CT between peritumoral and contralateral breast AT and most of the textural parameters of peritumoral AT, including mean FDG uptake, also showed significant differences between the patients with and without axillary lymph node metastasis.…”

“…The interaction between breast cancer cells and AT leads to enhanced glycolysis of adipocytes and inflammation in peritumoral AT [ 12 , 14 ], suggesting that peritumoral breast AT might also exhibit distinct FDG PET/CT features in patients with breast cancer, which could also have a significant association with tumor invasiveness and metastasis. In previous studies, FDG uptake of peritumoral AT in pancreatic, gastric, and prostate cancers demonstrated a significant association with tumor aggressiveness and prognosis [ 18 , 19 , 20 ]. However, until now, the clinical significance of FDG PET/CT imaging features of peritumoral breast AT have yet to be reported.…”

Thromboinflammatory Processes at the Nexus of Metabolic Dysfunction and Prostate Cancer: The Emerging Role of Periprostatic Adipose Tissue

“…Nevertheless, an under-studied AT that is particularly pertinent to the etiology of PCa is the periprostatic adipose tissue (PPAT) that is situated in the proximity of the prostate [ 17 ]. Indeed, PPAT dysfunction and inflammation not only amplify rudimentary neoplastic alterations of the healthy prostate, but also promote PCa progression, metastasis, and resistance to chemotherapy [ 17 , 18 , 19 , 20 , 21 , 22 ]. Compared to other adipose depots, the cellular and molecular heterogeneity as well as the thermogenic potential of PPAT remain largely uninvestigated.…”