DOI QR코드

DOI QR Code

Concurrent Low Brain and High Liver Uptake on FDG PET Are Associated with Cardiovascular Risk Factors

  • Nam, Hyun-Yeol (Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine) ;
  • Jun, Sungmin (Department of Nuclear Medicine, Kosin University Gospel Hospital, Kosin University College of Medicine) ;
  • Pak, Kyoungjune (Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital) ;
  • Kim, In Joo (Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital)
  • 투고 : 2016.07.23
  • 심사 : 2016.10.24
  • 발행 : 2017.04.01

초록

Objective: Concurrent low brain and high liver uptake are sometimes observed on fluorine-18-labeled fluoro-2-deoxy-Dglucose (FDG) positron emission tomography (PET). We investigated the potential clinical significance of this uptake pattern related to metabolic syndrome (MS). Materials and Methods: We retrospectively reviewed data from 264 consecutive males who had undergone general health check-ups, including FDG PET/CT scans. After an overnight fast, the men had their peripheral blood drawn and the levels of various laboratory parameters measured; an FDG PET/CT scan was performed on the same day. We measured the maximum standardized uptake values of the brain and liver from regions of interest manually placed over the frontal cortex at the level of the centrum semiovale and the right lobe of the liver parenchyma, respectively. Results: Fasting blood glucose (FBG; odds ratio [OR] = 1.063, p < 0.001) and glycated hemoglobin (HbA1c; OR = 3.634, p = 0.010) were the strongest predictive factors for low brain FDG uptake, whereas waist circumference (OR = 1.200, p < 0.001) and ${\gamma}$-glutamyl transpeptidase (OR = 1.012, p = 0.001) were the strongest predictive factors for high liver uptake. Eleven subjects (4.2%) showed concurrent low brain and high liver FDG uptake, and all but one of these subjects (90.9%) had MS. Systolic blood pressure, waist circumference, FBG, triglyceride, alanine aminotransferase, insulin resistance (measured by homeostasis model assessment), insulin, HbA1c, and body mass index were higher in subjects with this FDG uptake pattern than in those without (all, p < 0.001). Conclusion: Concurrent low brain and high liver FDG uptake were closely associated with MS. Moreover, subjects with this pattern had higher values for various cardiovascular risk factors than did those without.

키워드

참고문헌

  1. Strauss LG, Conti PS. The applications of PET in clinical oncology. J Nucl Med 1991;32:623-648; discussion 649-650
  2. Busing KA, Schonberg SO, Brade J, Wasser K. Impact of blood glucose, diabetes, insulin, and obesity on standardized uptake values in tumors and healthy organs on 18F-FDG PET/CT. Nucl Med Biol 2013;40:206-213 https://doi.org/10.1016/j.nucmedbio.2012.10.014
  3. Minamimoto R, Takahashi N, Inoue T. FDG-PET of patients with suspected renal failure: standardized uptake values in normal tissues. Ann Nucl Med 2007;21:217-222 https://doi.org/10.1007/s12149-007-0012-4
  4. Langbaum JB, Chen K, Launer LJ, Fleisher AS, Lee W, Liu X, et al. Blood pressure is associated with higher brain amyloid burden and lower glucose metabolism in healthy late middleage persons. Neurobiol Aging 2012;33:827.e11-e19 https://doi.org/10.1016/j.neurobiolaging.2011.06.020
  5. Reiman EM, Chen K, Langbaum JB, Lee W, Reschke C, Bandy D, et al. Higher serum total cholesterol levels in late middle age are associated with glucose hypometabolism in brain regions affected by Alzheimer's disease and normal aging. Neuroimage 2010;49:169-176 https://doi.org/10.1016/j.neuroimage.2009.07.025
  6. Miao Q, Zhang S, Guan YH, Ye HY, Zhang ZY, Zhang QY, et al. Reversible changes in brain glucose metabolism following thyroid function normalization in hyperthyroidism. AJNR Am J Neuroradiol 2011;32:1034-1042 https://doi.org/10.3174/ajnr.A2449
  7. Loessner A, Alavi A, Lewandrowski KU, Mozley D, Souder E, Gur RE. Regional cerebral function determined by FDG-PET in healthy volunteers: normal patterns and changes with age. J Nucl Med 1995;36:1141-1149
  8. Petit-Taboue MC, Landeau B, Desson JF, Desgranges B, Baron JC. Effects of healthy aging on the regional cerebral metabolic rate of glucose assessed with statistical parametric mapping. Neuroimage 1998;7:176-184 https://doi.org/10.1006/nimg.1997.0318
  9. Ivancevic' V, Alavi A, Souder E, Mozley PD, Gur RE, Benard F, et al. Regional cerebral glucose metabolism in healthy volunteers determined by fluordeoxyglucose positron emission tomography: appearance and variance in the transaxial, coronal, and sagittal planes. Clin Nucl Med 2000;25:596-602 https://doi.org/10.1097/00003072-200008000-00005
  10. Liu G, Li Y, Hu P, Cheng D, Shi H. The combined effects of serum lipids, BMI, and fatty liver on 18F-FDG uptake in the liver in a large population from China: an 18F-FDG-PET/CT study. Nucl Med Commun 2015;36:709-716 https://doi.org/10.1097/MNM.0000000000000301
  11. Kuruva M, Mittal BR, Abrar ML, Kashyap R, Bhattacharya A. Multivariate analysis of various factors affecting background liver and mediastinal standardized uptake values. Indian J Nucl Med 2012;27:20-23 https://doi.org/10.4103/0972-3919.108835
  12. Kubota K, Watanabe H, Murata Y, Yukihiro M, Ito K, Morooka M, et al. Effects of blood glucose level on FDG uptake by liver: a FDG-PET/CT study. Nucl Med Biol 2011;38:347-351 https://doi.org/10.1016/j.nucmedbio.2010.09.004
  13. Kamimura K, Nagamachi S, Wakamatsu H, Higashi R, Ogita M, Ueno S, et al. Associations between liver (18)F fluoro- 2-deoxy-D-glucose accumulation and various clinical parameters in a Japanese population: influence of the metabolic syndrome. Ann Nucl Med 2010;24:157-161 https://doi.org/10.1007/s12149-009-0338-1
  14. Lin CY, Ding HJ, Lin T, Lin CC, Kuo TH, Kao CH. Positive correlation between serum liver enzyme levels and standard uptake values of liver on FDG-PET. Clin Imaging 2010;34:109-112 https://doi.org/10.1016/j.clinimag.2009.05.007
  15. Lin CY, Ding HJ, Lin CC, Chen CC, Sun SS, Kao CH. Impact of age on FDG uptake in the liver on PET scan. Clin Imaging 2010;34:348-350 https://doi.org/10.1016/j.clinimag.2009.11.003
  16. Grundy SM, Cleeman JI, Daniels SR, Donato KA, Eckel RH, Franklin BA, et al. Diagnosis and management of the metabolic syndrome: an American Heart Association/National Heart, Lung, and Blood Institute Scientific Statement. Circulation 2005;112:2735-2752 https://doi.org/10.1161/CIRCULATIONAHA.105.169404
  17. Roy FN, Beaulieu S, Boucher L, Bourdeau I, Cohade C. Impact of intravenous insulin on 18F-FDG PET in diabetic cancer patients. J Nucl Med 2009;50:178-183 https://doi.org/10.2967/jnumed.108.056283
  18. Delbeke D, Meyerowitz C, Lapidus RL, Maciunas RJ, Jennings MT, Moots PL, et al. Optimal cutoff levels of F-18 fluorodeoxyglucose uptake in the differentiation of lowgrade from high-grade brain tumors with PET. Radiology 1995;195:47-52 https://doi.org/10.1148/radiology.195.1.7892494
  19. Adams MC, Turkington TG, Wilson JM, Wong TZ. A systematic review of the factors affecting accuracy of SUV measurements. AJR Am J Roentgenol 2010;195:310-320 https://doi.org/10.2214/AJR.10.4923
  20. Dekker JM, Girman C, Rhodes T, Nijpels G, Stehouwer CD, Bouter LM, et al. Metabolic syndrome and 10-year cardiovascular disease risk in the Hoorn study. Circulation 2005;112:666-673 https://doi.org/10.1161/CIRCULATIONAHA.104.516948
  21. Ford ES, Li C, Zhao G. Prevalence and correlates of metabolic syndrome based on a harmonious definition among adults in the US. J Diabetes 2010;2:180-193 https://doi.org/10.1111/j.1753-0407.2010.00078.x
  22. Crippa F, Gavazzi C, Bozzetti F, Chiesa C, Pascali C, Bogni A, et al. The influence of blood glucose levels on [18F] fluorodeoxyglucose (FDG) uptake in cancer: a PET study in liver metastases from colorectal carcinomas. Tumori 1997;83:748-752 https://doi.org/10.1177/030089169708300407
  23. Lindholm P, Minn H, Leskinen-Kallio S, Bergman J, Ruotsalainen U, Joensuu H. Influence of the blood glucose concentration on FDG uptake in cancer--a PET study. J Nucl Med 1993;34:1-6
  24. Cheung JY, Conover C, Regen DM, Whitfield CF, Morgan HE. Effect of insulin on kinetics of sugar transport in heart muscle. Am J Physiol 1978;234:E70-E78
  25. Sun D, Nguyen N, DeGrado TR, Schwaiger M, Brosius FC 3rd. Ischemia induces translocation of the insulin-responsive glucose transporter GLUT4 to the plasma membrane of cardiac myocytes. Circulation 1994;89:793-798 https://doi.org/10.1161/01.CIR.89.2.793
  26. Nathan DM, Turgeon H, Regan S. Relationship between glycated haemoglobin levels and mean glucose levels over time. Diabetologia 2007;50:2239-2244 https://doi.org/10.1007/s00125-007-0803-0
  27. Talbot K, Wang HY, Kazi H, Han LY, Bakshi KP, Stucky A, et al. Demonstrated brain insulin resistance in Alzheimer's disease patients is associated with IGF-1 resistance, IRS- 1 dysregulation, and cognitive decline. J Clin Invest 2012;122:1316-1338 https://doi.org/10.1172/JCI59903
  28. Messier C, Teutenberg K. The role of insulin, insulin growth factor, and insulin-degrading enzyme in brain aging and Alzheimer's disease. Neural Plast 2005;12:311-328 https://doi.org/10.1155/NP.2005.311
  29. Deng Y, Li B, Liu Y, Iqbal K, Grundke-Iqbal I, Gong CX. Dysregulation of insulin signaling, glucose transporters, O-GlcNAcylation, and phosphorylation of tau and neurofilaments in the brain: implication for Alzheimer's disease. Am J Pathol 2009;175:2089-2098 https://doi.org/10.2353/ajpath.2009.090157
  30. Smith SR, Ravussin E. Emerging paradigms for understanding fatness and diabetes risk. Curr Diab Rep 2002;2:223-230 https://doi.org/10.1007/s11892-002-0087-1
  31. Kubota R, Yamada S, Kubota K, Ishiwata K, Tamahashi N, Ido T. Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. J Nucl Med 1992;33:1972-1980
  32. Wellen KE, Hotamisligil GS. Inflammation, stress, and diabetes. J Clin Invest 2005;115:1111-1119 https://doi.org/10.1172/JCI25102
  33. Rector RS, Thyfault JP, Wei Y, Ibdah JA. Non-alcoholic fatty liver disease and the metabolic syndrome: an update. World J Gastroenterol 2008;14:185-192 https://doi.org/10.3748/wjg.14.185
  34. Marchesini G, Brizi M, Bianchi G, Tomassetti S, Bugianesi E, Lenzi M, et al. Nonalcoholic fatty liver disease: a feature of the metabolic syndrome. Diabetes 2001;50:1844-1850 https://doi.org/10.2337/diabetes.50.8.1844
  35. Lee DH, Jacobs DR Jr. Association between serum gammaglutamyltransferase and C-reactive protein. Atherosclerosis 2005;178:327-330 https://doi.org/10.1016/j.atherosclerosis.2004.08.027
  36. Kang YH, Min HK, Son SM, Kim IJ, Kim YK. The association of serum gamma glutamyltransferase with components of the metabolic syndrome in the Korean adults. Diabetes Res Clin Pract 2007;77:306-313 https://doi.org/10.1016/j.diabres.2006.11.009
  37. Zasadny KR, Wahl RL. Standardized uptake values of normal tissues at PET with 2-[fluorine-18]-fluoro-2-deoxy-D-glucose: variations with body weight and a method for correction. Radiology 1993;189:847-850 https://doi.org/10.1148/radiology.189.3.8234714
  38. Lindholm H, Johansson O, Jonsson C, Jacobsson H. The distribution of FDG at PET examinations constitutes a relative mechanism: significant effects at activity quantification in patients with a high muscular uptake. Eur J Nucl Med Mol Imaging 2012;39:1685-1690 https://doi.org/10.1007/s00259-012-2202-0

피인용 문헌

  1. Global and regional brain hypometabolism on FDG-PET in treated HIV-infected individuals vol.91, pp.17, 2017, https://doi.org/10.1212/wnl.0000000000006398
  2. Age of Data in Contemporary Research Articles Published in Representative General Radiology Journals vol.19, pp.6, 2018, https://doi.org/10.3348/kjr.2018.19.6.1172
  3. Characterization of glucose uptake metabolism in visceral fat by 18  F-FDG PET/CT reflects inflammatory status in metabolic syndrome vol.15, pp.2, 2020, https://doi.org/10.1371/journal.pone.0228602
  4. Glucose-level dependent brain hypometabolism in type 2 diabetes mellitus and obesity vol.5, pp.1, 2021, https://doi.org/10.1186/s41824-021-00097-z