Journal
ACTA RADIOLOGICA
Volume 62, Issue 4, Pages 557-564Publisher
SAGE PUBLICATIONS LTD
DOI: 10.1177/0284185120932378
Keywords
FDG PET; hypoxia-inducible factor-1 alpha; HIF-1 alpha
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The study aimed to provide clear data about the associations between maximum standardized uptake value (SUVmax) and HIF-1 alpha expression in solid tumors. The results showed a weak correlation between SUVmax of FDG PET and HIF-1 alpha in both overall sample and tumor subgroups.
Background Hypoxia-inducible factor (HIF)-1 alpha plays a key role in hypoxic adaptation of tumor cells. Overexpression of HIF-1 alpha is associated with tumor aggressiveness and worse prognosis in several malignancies. Presumably, expression of HIF-1a may be reflected by positron emission tomography with 2-deoxy-2 [fluorine-18] fluoro-D-glucose (18F-FDG PET). There are inconsistent data about relationships between FDG PET and HIF-1 alpha. Purpose To provide evident data about associations between maximum standardized uptake value (SUVmax) and HIF-1 alpha expression in solid tumors. Material and Methods MEDLINE, SCOPUS, and EMBASE databases were screened for relationships between SUV and HIF-1 alpha up to August 2019. Overall, 21 studies with 1154 patients were identified. The following data were extracted from the literature: authors; year of publication; number of patients; and correlation coefficients. Results Correlation coefficients between SUV(max)and HIF-1 alpha were in the range of -0.51-0.71. The pooled correlation coefficient was 0.27 (95% confidence interval [CI] = 0.14-0.41). Furthermore, correlation coefficients for some tumor entities were calculated. For this sub-analysis, data for primary tumors with >2 reports were included. The calculated correlation coefficients in the analyzed subgroups were as follows: head and neck squamous cell carcinoma: rho = 0.25 (95% CI = 0.07-0.42); non-small lung cell cancer: rho = 0.27 (95% CI = -0.14-0.67); uterine cervical cancer: rho = -0.09 (95% CI = -0.89-0.71); thymic tumors: rho = 0.39 (95% CI = 0.04-0.58). Conclusion SUV(max)of FDG PET correlated weakly with expression of HIF-1 alpha both in overall sample and tumor subgroups. Therefore, FDG PET cannot be used for prediction of hypoxia in clinical practice.
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