Cardiac 18F‑FDG uptake and new‑onset rectal cancer

Area of Science:

• Oncology
• Nuclear Medicine
• Radiology

Background:

• 18F-fluorodeoxyglucose (18F-FDG) Positron Emission Tomography (PET) is crucial for cancer staging.
• Cardiac uptake of 18F-FDG can be influenced by various factors and may have prognostic implications.
• Understanding these factors is essential for accurate cancer assessment and patient management.

Purpose of the Study:

• To investigate factors influencing cardiac 18F-FDG uptake in patients with new-onset rectal and colon cancer.
• To examine the association between cardiac 18F-FDG uptake and the presence of distant metastasis.
• To evaluate the relationship between cardiac 18F-FDG uptake and overall survival in these patient groups.

Main Methods:

• Retrospective analysis of 26 patients with new-onset rectal cancer and 25 with new-onset colon cancer who underwent 18F-FDG PET for staging.
• Correlation of cardiac maximum standard uptake value (SUVmax) with distant metastasis, tumor volume, and echocardiography findings.
• Prognostic analysis using overall survival data, correlating it with cardiac SUVmax, tumor volume, and metastasis presence.

Main Results:

• In rectal cancer, lower cardiac SUVmax was significantly associated with the presence of distant metastasis (P<0.01) and poorer overall survival (HR: 0.06, P<0.01).
• A cardiac SUVmax cutoff of 2.6 demonstrated high accuracy (AUC 0.86) in predicting distant metastasis.
• No statistically significant association was found between cardiac SUVmax and distant metastasis in new-onset colon cancer patients.

Conclusions:

• Cardiac 18F-FDG uptake is a potential independent prognostic biomarker for new-onset rectal cancer, predicting metastasis and survival.
• The findings suggest that cardiac SUVmax may aid in risk stratification for rectal cancer patients.
• Further research is warranted to explore the clinical utility of cardiac 18F-FDG uptake in colon cancer management.