Relationship between [F-18]FDG PET/CT and metabolomics in patients with colorectal cancer

Introduction Advances in metabolomics have significantly improved cancer detection, diagnosis, treatment, and prognosis. Objectives To investigate the relationship between metabolic tumor volume (MTV) using 2-deoxy-2-[F-18]fluoro-D-glucose (FDG) positron emission tomography (PET)/ computed tomography (CT) and metabolomics data in patients with colorectal cancer (CRC). Methods The metabolome in tumor tissues was analyzed using capillary electrophoresis time-of-flight mass spectrometry in 33 patients with newly diagnosed CRC who underwent FDG PET/CT before treatment and had tumor tissue post-surgery. Based on the FDG PET data, MTV was calculated and was dichotomized according to the median value, and tumors were divided into low-MTV and high-MTV tumors. Metabolomics data were compared between the low-MTV and high-MTV tumors. Results The levels of most glycolysis-related metabolites were not different between low-MTV and high-MTV tumors. The level of component of the initial part of the tricarboxylic acid (TCA) cycle, citrate, was significantly lower in the high-MTV tumor than in the low-MTV tumor. The TCA intermediate succinate level was significantly higher in the high-MTV tumor than in the low-MTV tumor. In contrast, the TCA intermediate fumarate level was significantly lower in the high-MTV tumor than in the low-MTV tumor. The levels of many amino acids were significantly higher in the high-MTV tumor than in the low-MTV tumor. Conclusions Although preliminary, these results suggest that tumors with high FDG metabolism in CRC may obtain more energy by using a reverse reaction of the TCA cycle and amino-acid metabolism. However, further research is required to clarify this relationship.

Automated summary

This study investigated the relationship between metabolic tumor volume (MTV) and metabolomics data in patients with colorectal cancer (CRC). The results suggest that tumors with high FDG metabolism in CRC may rely on a reverse reaction of the TCA cycle and amino-acid metabolism for energy production.