Home » Key Scientific Articles » 18[F]FDG-PET/CT is a useful molecular marker in evaluating tumour aggressiveness: a revised understanding of an in-vivo FDG-PET imaging that alludes the alteration of cancer biology.

18[F]FDG-PET/CT is a useful molecular marker in evaluating tumour aggressiveness: a revised understanding of an in-vivo FDG-PET imaging that alludes the alteration of cancer biology.

Fathinul F, Nordin AJ, Lau WF.

Cell Biochem Biophys. 2013 May;66(1):37-43.

Centre for Diagnostic Nuclear Imaging, Universiti Putra Malaysia, Serdang, Selangor, Malaysia. [email protected]

 

Abstract

Molecular imaging employing (18)[F]FDG-PET/CT enables in-vivo visualization, characterisation and measurement of biological process in tumour at the molecular and cellular level. In oncology, this approach can be directly applied as translational biomarkers of disease progression. In this article, the improved roles of FDG as an in-vivo glycolytic marker which reflect biological changes across in-vitro cellular environment are discussed. New understanding in how altered metabolism via glycolytic downstream drivers of malignant transformation as reviewed below offers unique promise as to monitor tumour aggressiveness and hence optimize the therapeutic management.


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Additional Information

 

Heterogeneity of malignant cells in different sites within a tumor is a manifestation of genomic instability that characterizes cancer cells.  Standardized uptake value (SUVmax) exploited from the positron emission tomography (PET) technique is a potentially good surrogate marker for cancer aggressiveness and in predicting disease prognosis.  SUVmax is a key signaling tool that allude the altered glucose metabolism via semiquatification of the flurodeoxglucose (FDG) concentration in cancer cells. FDG is tagged with PET tracer – Fluorine-18 whereby its affinity in an altered glycolitic cells can construe the stage of a particular cancer cellular differentiation.  SUVmax can range from more than 2.5 to above 10 in various types of cancer lineage as reported in many studies.  The role of this non-invasive cancer signaling has leveraged scientific innovation in molecular imaging via amelioration of its intuitive role in specific tumour i.e thymoma, neuroendocrine tumor and multiple myeloma. In thymoma,  tumor histology alone is incapable of  differentiating tumor cellular aggressiveness.  SUVmax is also helpful in stratifying neuroendocrine tumor for which combination of dual- tracer technique with Ga-68 would ensure which PET patterns would suite appropriate treatments. In addition, a low level of  molecular marker i.e. Interleukin -6 in multiple myeloma which is inversely correlated with high proliferating cells in such tumor entity may  pose false impression of the true tumor aggressiveness ( tumor cells may lack proliferating power at their terminal differentiation stage)- OF Ballister 1994. The use of SUVmax are deemed to changes in perception towards how it would benefits patients with cancer and its influence on the drug discoveries.

 

Figure Legend

Standardised uptake value (SUVmax) of Positron Emission Tomography (PET) underpins the cellular reprogramming of cancer proliferation.

 

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