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D. Oliver

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    P1.03 - Poster Session with Presenters Present (ID 455)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Radiology/Staging/Screening
    • Presentations: 1
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      P1.03-020 - FDG-PET SUVmax Does Not Correlate with Glucose Metabolism in Non-Small Cell Lung Cancer (ID 6418)

      14:30 - 15:45  |  Author(s): D. Oliver

      • Abstract

      In non-small cell lung cancer (NSCLC),[ 18]fluoro-2-deoxyglucose positron emission tomography (FDG-PET) assists in diagnosing, staging, and evaluating treatment response. One parameter of the FDG-PET, the maximum standard uptake value (SUV~max~), has been used as an objective measure of cancer viability and that FDG accumulation is the result of altered tumor glycolysis. The objective of this investigation is to use metabolic flux analysis to determine if the SUV~max~ is predictive of tumor metabolism.

      In this prospective human subjects-approved clinical trial, 22 untreated potentially-resectable patients with confirmed NSCLC underwent FDG-PET computed tomography and dynamic contrast enhanced (DCE) magnetic resonance imaging. On the day of surgery, the patients received an intravenous bolus and then continuous infusion of [13]C-glucose for 3 hours prior to resection. Blood samples were routinely taken and after the lung cancer was removed, biopsies from tumor (T) and normal lung (NL). Blood and tissue metabolite mass spectrometry analysis was performed and compared with clinical parameters including SUV~max~, DCE tissue perfusion, oncogenotype, tumor volume (TV), stage, and grade.

      There were 7 males, 8 never-smokers, mean age 67 (43-84), mean TV 18.7 cm[3] (1.3-171.9), and mean SUVm 11.8 (0.7-32.0; 3 were < 2.5). The most relevant metabolite and clinical data can be found in Spearman Correlation Analysis in Figure 1. T relative to NL revealed increased glycolysis and glucose oxidation. SUV~max~ did not correlate with any glucose-dependent metabolites. TV correlated with metabolic markers related to fuel choice, larger tumors trending to use an alternative nutrient, including lactate.Figure 1

      Although all FDG-PET-positive tumors metabolized glucose, the SUVmax did not predict the overall extent or any specific pathway of glucose metabolism. TV predicts a propensity to consume alternative fuels, such as lactate, in addition to glucose.