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

Sawaragi,Kazuhito; Okada,Yukinori; Aono,Yuuki; Yasuoka,Ryo; Takayama,Shoji; Yao,Ryuuji; Mitsuyama,Toshiyuki; Saigusa,Susumu; Fujikawa,Hiroyuki; Mori,Tomomi; Hashimoto,Manabu; Higashi,Koki; Sakurai,Hiroyuki; Tanaka,Koji; Okugawa,Yoshinaga; Tanaka,Naoshi; Toiyama,Yuji; Okazaki,Kazuichi; Naganuma,Makoto

doi:10.3892/ol.2023.13783

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

Authors:
- Kazuhito Sawaragi
- Yukinori Okada
- Yuuki Aono
- Ryo Yasuoka
- Shoji Takayama
- Ryuuji Yao
- Toshiyuki Mitsuyama
- Susumu Saigusa
- Hiroyuki Fujikawa
- Tomomi Mori
- Manabu Hashimoto
- Koki Higashi
- Hiroyuki Sakurai
- Koji Tanaka
- Yoshinaga Okugawa
- Naoshi Tanaka
- Yuji Toiyama
- Kazuichi Okazaki
- Makoto Naganuma
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Affiliations: Department of Gastroenterology and Hepatology, Iga City General Hospital, Iga, Mie 518‑0823, Japan, Department of Radiology, Iga City General Hospital, Iga, Mie 518‑0823, Japan, Department of Gastroenterology and Hepatology, Kansai Medical University, Hirakata, Osaka 573‑1191, Japan, Department of Surgery, Iga City General Hospital, Iga, Mie 518‑0823, Japan, Department of Genomic Medicine, Mie University, Tsu, Mie 514‑0102, Japan, Department of Radiology, Oyamada Memorial Spa Hospital, Yokkaichi, Mie 512‑1111, Japan, Department of Gastrointestinal and Pediatric Surgery, Mie University, Tsu, Mie 514‑0102, Japan
Published online on: April 3, 2023 https://doi.org/10.3892/ol.2023.13783
Article Number: 197
Copyright: © Sawaragi et al. This is an open access article distributed under the terms of Creative Commons Attribution License.

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Abstract

The present study aimed to investigate the factors affecting the cardiac uptake of 18F‑fluorodeoxyglucose (18F‑FDG) during 18F‑FDG positron emission tomography (PET) for new‑onset rectal cancer and new‑onset colon cancer (ascending, transverse, descending, sigmoid colon cancer) and to examine the association between the cardiac uptake of 18F‑FDG and prognosis. The participants were diagnosed with new‑onset rectal cancer and new‑onset colon cancer (ascending, transverse, descending, sigmoid cancer) at the Iga City General Hospital (Iga, Japan) between January 1, 2013, and March 31, 2018, and underwent an 18F‑FDG PET scan for pretreatment staging. The relationship between cardiac maximum standard uptake value (SUVmax), the presence/absence of distant metastasis and prognosis was examined. A total of 26 patients (14 men and 12 women) aged 72.0±10 years with new‑onset rectal cancer were selected for the study. No patients had multiple simultaneous cancers. The median cardiac SUVmax was 3.8 and 2.5 in patients with no distant metastasis and distant metastasis, respectively, revealing a statistically significant difference (P<0.01). The median tumor volume on PET‑computed tomography (CT) images was 7,815 cm2 and was 66,248 cm2 in patients with no distant metastasis and distant metastasis, respectively, revealing a statistically significant difference (P<0.01). Echocardiography findings revealed no significant difference between patients with and without distant metastasis. The correlation coefficient between cardiac SUVmax and total tumor volume on PET/CT images (primary + lymph + distant metastases) was statistically significant (r=‑0.42, P=0.03). Analysis of the association between the occurrence of distance metastasis and cardiac SUVmax as a continuous variable gave a statistically significant result [hazard ratio (HR): 0.30, 95% confidence interval (CI): 0.09‑0.98, P=0.045]. Receiver operating characteristic analysis showed a cardiac SUVmax of 2.6 with an area under the curve of 0.86 for determining the presence of distant metastasis (95% CI: 0.70‑1.00). The median observation time was 56 months, and nine patients died during observation. Analysis of the association between the overall survival and cardiac SUVmax (cutoff: 2.6) showed 95% CI: 0.01‑0.45 and HR: 0.06 (P<0.01); that between the overall survival and total tumor volume on PET images showed 95% CI: 1.00‑1.00 and HR: 1.00 (P<0.01); and that between the overall survival and presence of distant metastasis showed 95% CI: 1.72‑116.4 and HR: 14.1 (P<0.01). Furthermore, 25 patients (16 men and nine women) aged 71.4±14.2 years with new‑onset colon cancer were selected for the study. Analysis of new‑onset colon cancer revealed no statistically significance between the cardiac SUVmax and distant metastasis.

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