Prognostic Significance of the Bone Marrow-to-Aorta Uptake Ratio on 2-Deoxy-2-[¹⁸F]fluoro-d-glucose Positron Emission...

Area of Science:

• Oncology
• Nuclear Medicine
• Radiomics

Background:

• Reticuloendothelial system FDG uptake on PET/CT correlates with systemic inflammation in cancer.
• Cholangiocarcinoma prognosis is influenced by systemic inflammatory responses.

Purpose of the Study:

• To evaluate the prognostic value of FDG uptake ratios in the reticuloendothelial system for predicting survival in cholangiocarcinoma patients.
• To investigate the association between FDG uptake ratios and tumor stage or inflammatory markers.

Main Methods:

• Retrospective analysis of 138 cholangiocarcinoma patients undergoing staging FDG PET/CT.
• Quantification of FDG uptake in aorta, bone marrow (BM), liver, and spleen.
• Calculation of BM-to-aorta uptake ratio (BAR), spleen-to-aorta uptake ratio, and BM-to-liver uptake ratio.
• Multivariate survival analysis to identify independent predictors of progression-free survival (PFS) and overall survival (OS).

Main Results:

• Significant correlations were found between BAR, spleen-to-aorta uptake ratio, BM-to-liver uptake ratio, tumor stage, and serum inflammatory markers.
• BAR independently predicted PFS (p=0.016) and OS (p=0.030).
• High BAR in stages III-IV patients was associated with low 1-year PFS (35.8%) and OS (60.2%).
• Low BAR in stages I-II patients showed high 1-year PFS (90.0%) and OS (96.7%).

Conclusions:

• The BM-to-aorta uptake ratio (BAR) is a potential imaging biomarker for predicting prognosis in cholangiocarcinoma.
• BAR offers insights into systemic inflammation and may aid in personalized prognostication and treatment strategies.