Brain glucose metabolism on [18F]-FDG PET/CT: a dynamic biomarker predicting depression and anxiety in cancer patients

Xue Yang; Guangxia Yang; Ruojun Wang; Yanjuan Wang; Shengyi Zhang; Jian Wang; Chunjing Yu; Zeqin Ren

doi:10.3389/fonc.2023.1098943

Brain glucose metabolism on [18F]-FDG PET/CT: a dynamic biomarker predicting depression and anxiety in cancer patients

Front Oncol. 2023 May 25:13:1098943. doi: 10.3389/fonc.2023.1098943. eCollection 2023.

Authors

Xue Yang¹, Guangxia Yang², Ruojun Wang¹, Yanjuan Wang³, Shengyi Zhang¹, Jian Wang⁴, Chunjing Yu³, Zeqin Ren⁵

Affiliations

¹ Department of Neurology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China.
² Department of Rheumatology, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China.
³ Department of Nuclear Medicine, Affiliated Hospital of Jiangnan University, Jiangnan University, Wuxi, Jiangsu, China.
⁴ Department of Orthopaedics, The Ninth People's Hospital of Wuxi, Affiliated to Suzhou University, Wuxi, Jiangsu, China.
⁵ Department of Rehabilitation, The First Affiliated Hospital of Dali University, Dali, Yunnan, China.

Abstract

Objectives: To explore the correlation between the incidence rates of depression and anxiety and cerebral glucose metabolism in cancer patients.

Methods: The experiment subjects consisted of patients with lung cancer, head and neck tumor, stomach cancer, intestinal cancer, breast cancer and healthy individuals. A total of 240 tumor patients and 39 healthy individuals were included. All subjects were evaluated by the Hamilton depression scale (HAMD) and Manifest anxiety scale (MAS), and were examined by whole body Positron Emission Tomography/Computed Tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG). Demographic, baseline clinical characteristics, brain glucose metabolic changes, emotional disorder scores and their relations were statistically analyzed.

Results: The incidence rates of depression and anxiety in patients with lung cancer were higher than those in patients with other tumors, and Standard uptake values (SUVs) and metabolic volume in bilateral frontal lobe, bilateral temporal lobe, bilateral caudate nucleus, bilateral hippocampus, left cingulate gyrus were lower than those in patients with other tumors. We also found that poor pathological differentiation, and advanced TNM stage independently associated with depression and anxiety risk. SUVs in the bilateral frontal lobe, bilateral temporal lobe, bilateral caudate nucleus, bilateral hippocampus, left cingulate gyrus were negatively correlated with HAMD and MAS scores.

Conclusion: This study revealed the correlation between brain glucose metabolism and emotional disorders in cancer patients. The changes in brain glucose metabolism were expected to play a major role in emotional disorders in cancer patients as psychobiological markers. These findings indicated that functional imaging can be applied for psychological assessment of cancer patients as an innovative method.

Keywords: anxiety disorder; cancer; depression; glucose metabolism; positron emission.

Grants and funding

This work was supported by National Natural Science Foundation of China (grant no.82060895),Basic Research Plan of Yunnan Provincial Science and Technology Department(202101BA070001-123).