International Journal of Hematology and Oncology
2023, Vol 33, Num 4 Page(s): 069-078
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High Metabolic Tumor Volume and Total Lesion Glycolysis Derived from Baseline 18F-FDG PET/CT may Predict the Metabolic Abnormalities in Newly Diagnosed Cancer Patients
Aysun CETIN1, Ummuhan ABDULREZZAK2, Semih YILMAZ1,7, Gokmen ZARARSIZ3, Soner AKKURT4, Mahmut UCAR5, Leylagül KAYNAR5, Esra YILDIZHAN5, Esra E. TURAK5, Ersin OZASLAN5, Kursat GUNDOGAN6, Mevlude INANC5, Mustafa KULA2, Mustafa CETIN5
1Erciyes University, Faculty of Medicine, Department of Medical Biochemistry, Kayseri, TURKEY
2Erciyes University, Faculty of Medicine, Department of Nuclear Medicine, Kayseri, TURKEY
3Erciyes University, Faculty of Medicine, Department of Biostatistics, Kayseri, TURKEY
4Erciyes University, Faculty of Medicine, Department of Sports Medicine, Kayseri, TURKEY
5Erciyes University, Faculty of Medicine, Department of Haematology and Oncology, Kayseri, TURKEY
6Erciyes University, Faculty of Medicine, Department of Internal Medicine, Kayseri, TURKEY
7Erciyes University, Faculty of Agriculture, Department of Enzyme and Microbial Biotechnology, Kayseri, TURKEY
Keywords: MTV, TLG, BMR, lung cancer, breast cancer
The present study was conducted to investigate the role of total body Metabolic Tumor Volume (MTV, mm3) and Total Lesion Glycolysis (TLG) values obtained by PET/CT imaging for predicting metabolic abnormalities in newly diagnosed cancer patients. Patients having solid tumors with initial PET/CT staging were evaluated in a prospective cohort study. MTV and TLG values of all patients were measured besides SUV values as PET/CT parameters. Initial metabolic status of patients was evaluated based on basal metabolic rates, serum vitamin, mineral, and biochemical metabolite levels and antioxidant enzyme capacities. The MTV and TLG levels revealed significant relationships with cancer-induced metabolic abnormalities as high BMR and LDH, and low albumin levels as well as advanced stage and presence of metastasis (p< 0.05). Cut-off values along with sensitivity and specificity rates in terms of high BMR (>20 Kcal/kg) were obtained to be > 52400 mm3 for MTV (0.84 and 0.63) and >274208 for TLG (0.84 and 0.63). The same values for high LDH were ≥ 219520 mm3 (0.52 and 0.88) for MTV and ≥ 411792 (0.78 and 0.58) for TLG, respectively. The values for low albumin levels were ≥89520 mm3 (0.63 and 0.10) for MTV, and ≥ 887840 (0.75 and 1.00 ) for TLG, respectively. In conclusion, MTV and TLG cut-off values determined by ROC analysis can predict metabolic abnormalities in initial BMR, LDH and albumin levels with high specificity and sensitivity. It is recommended to test MTV and TLG levels to determine initial metabolic status of diverse patient groups with various types of cancer.
Aysun CETIN1, Ummuhan ABDULREZZAK2, Semih YILMAZ1,7, Gokmen ZARARSIZ3, Soner AKKURT4, Mahmut UCAR5, Leylagül KAYNAR5, Esra YILDIZHAN5, Esra E. TURAK5, Ersin OZASLAN5, Kursat GUNDOGAN6, Mevlude INANC5, Mustafa KULA2, Mustafa CETIN5
1Erciyes University, Faculty of Medicine, Department of Medical Biochemistry, Kayseri, TURKEY
2Erciyes University, Faculty of Medicine, Department of Nuclear Medicine, Kayseri, TURKEY
3Erciyes University, Faculty of Medicine, Department of Biostatistics, Kayseri, TURKEY
4Erciyes University, Faculty of Medicine, Department of Sports Medicine, Kayseri, TURKEY
5Erciyes University, Faculty of Medicine, Department of Haematology and Oncology, Kayseri, TURKEY
6Erciyes University, Faculty of Medicine, Department of Internal Medicine, Kayseri, TURKEY
7Erciyes University, Faculty of Agriculture, Department of Enzyme and Microbial Biotechnology, Kayseri, TURKEY
Keywords: MTV, TLG, BMR, lung cancer, breast cancer
The present study was conducted to investigate the role of total body Metabolic Tumor Volume (MTV, mm3) and Total Lesion Glycolysis (TLG) values obtained by PET/CT imaging for predicting metabolic abnormalities in newly diagnosed cancer patients. Patients having solid tumors with initial PET/CT staging were evaluated in a prospective cohort study. MTV and TLG values of all patients were measured besides SUV values as PET/CT parameters. Initial metabolic status of patients was evaluated based on basal metabolic rates, serum vitamin, mineral, and biochemical metabolite levels and antioxidant enzyme capacities. The MTV and TLG levels revealed significant relationships with cancer-induced metabolic abnormalities as high BMR and LDH, and low albumin levels as well as advanced stage and presence of metastasis (p< 0.05). Cut-off values along with sensitivity and specificity rates in terms of high BMR (>20 Kcal/kg) were obtained to be > 52400 mm3 for MTV (0.84 and 0.63) and >274208 for TLG (0.84 and 0.63). The same values for high LDH were ≥ 219520 mm3 (0.52 and 0.88) for MTV and ≥ 411792 (0.78 and 0.58) for TLG, respectively. The values for low albumin levels were ≥89520 mm3 (0.63 and 0.10) for MTV, and ≥ 887840 (0.75 and 1.00 ) for TLG, respectively. In conclusion, MTV and TLG cut-off values determined by ROC analysis can predict metabolic abnormalities in initial BMR, LDH and albumin levels with high specificity and sensitivity. It is recommended to test MTV and TLG levels to determine initial metabolic status of diverse patient groups with various types of cancer.
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