Diffusely Decreased Liver Uptake on FDG PET and Cancer-Associated Cachexia With Reduced Survival

Clin Nucl Med. 2019 Aug;44(8):634-642. doi: 10.1097/RLU.0000000000002658.

Abstract

Objectives: We investigated clinical characteristics of patients with extremely increased or decreased physiologic F-FDG uptake of the liver and their prognosis.

Methods: One thousand four hundred eighty-seven PET/CT scans of patients with known or suspected malignancy were retrospectively analyzed. A spherical volume of interest (3 cm in diameter) was set on the right lobe of the liver to calculate the SUVmean. Scans with extremely high (SUVmean >97.5th percentile) and low (SUVmean <2.5th percentile) FDG uptake in the liver were evaluated. Physical and laboratory data among a control group (n = 30), the extremely high liver uptake group (HG, n = 36), and the extremely low liver uptake group (LG, n = 36) were compared. Overall survival (OS) of the 3 groups was also compared.

Results: Body weight and body mass index in the HG (SUVmean ≥3.04) were significantly higher than those in the control group. The LG cases (SUVmean ≤1.78) had anemia, impaired liver function, and systemic inflammation. They were also in a poor nutritional state. The characteristics of LG cases had many things in common with those of cachectic patients. Indeed, 36.1% of LG cases met the diagnostic criteria for cachexia. Moreover, in LG cases with viable and/or recurrent malignant lesions on FDG PET, the proportion of cachexia increased by 52.6%. The OS of LG cases (median, 33 months) was significantly worse than that of controls and HG cases.

Conclusions: Our data indicate that cancer patients with extremely decreased liver FDG uptake were likely to have cancer cachexia and a lower OS.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biological Transport
  • Cachexia / complications*
  • Cachexia / diagnostic imaging*
  • Cachexia / metabolism
  • Female
  • Fluorodeoxyglucose F18 / metabolism*
  • Humans
  • Liver / diagnostic imaging*
  • Liver / metabolism*
  • Male
  • Middle Aged
  • Neoplasms / complications*
  • Positron Emission Tomography Computed Tomography*
  • Prognosis
  • Retrospective Studies
  • Young Adult

Substances

  • Fluorodeoxyglucose F18