Whole Body Muscle Activity During Weightlifting Exercise Evaluated By Positron Emission Tomography

Background: This study investigated the whole-body skeletal muscle activity pattern of hang power clean (HPC), a major weight training exercise, using positron emission tomography (PET). Methods: Twelve college weightlifting athletes performed three sets of HPC 20 times with a barbell set to 40 kg both before and after an intravenous injection of 37 MBq 18F-fluorodeoxyglucose (FDG). PET-computed tomography images were obtained 50 min after FDG injection. Regions of interest were defined within 71 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume, and FDG accumulation was compared to the control group. The Mann–Whitney U-test was used to evaluate the differences in the mean SUV between groups. The difference between SUVs of the right and left muscles was evaluated by a paired t-test. A P-value <0.05 was considered statistically significant.Results: FDG accumulation within the vastus lateralis, vastus intermedius, and vastus medialis was higher than that of the rectus femoris. FDG accumulation within the triceps surae muscle was significantly higher only in the soleus. In the trunk and hip muscles, FDG accumulation of only the erector spinae was significantly increased. In all skeletal muscles, there was no difference between SUVs of the right and left muscles.Conclusions: The monoarticular muscles in the lower limbs were active in HPC. In contrast, deep muscles in the trunk and hip were not active during HPC. HPC is not suitable for core training and needs to be supplemented with other training.

Whole body muscle activity during weightlifting exercise evaluated by positron emission tomography

BackgroundThis study investigated the whole-body skeletal muscle activity pattern of hang power clean (HPC), a major weight training exercise, using positron emission tomography (PET).MethodTwelve college weightlifting athletes performed three sets of HPC 20 times with a barbell set to 40 kg both before and after an intravenous injection of 37 MBq 18F-fluorodeoxyglucose (FDG). PET-computed tomography images were obtained 50 min after FDG injection. Regions of interest were defined within 71 muscles. The standardized uptake value was calculated to examine the FDG uptake of muscle tissue per unit volume, and FDG accumulation was compared to the control group. The Mann–Whitney U-test was used to evaluate the differences in the mean SUV between groups. The difference between SUVs of the right and left muscles was evaluated by a paired t-test. A P-value < 0.05 was considered statistically significant.ResultsFDG accumulation within the vastus lateralis, vastus intermedius, and vastus medialis was higher than that of the rectus femoris. FDG accumulation within the triceps surae muscle was significantly higher only in the soleus. In the trunk and hip muscles, FDG accumulation of only the erector spinae was significantly increased. In all skeletal muscles, there was no difference between SUVs of the right and left muscles.ConclusionsThe monoarticular muscles in the lower limbs were active in HPC. In contrast, deep muscles in the trunk and hip were not active during HPC. HPC is not suitable for core training and needs to be supplemented with other training.

MRI, CT and FDG-PET/CT findings of Wolffian tumor: four-case series

Abstarct Purpose The purpose of this study is to describe the characteristic MRI, CT, and 18F-fluorodeoxyglucose-positron emission tomography/computed tomography (FDG-PET/CT) findings of Wolffian tumor. Methods We reviewed preoperative images in four surgical cases of Wolffian tumor. MRI was available for review in all cases with additional diffusion-weighted images (DWI) in three, and contrast-enhanced images in two. CT was available in three. FDG-PET/CT was obtained in two. Results Two patients were asymptomatic, while the other two presented with acute abdomen. On MRI, all tumors were well-defined masses of increased signals on T2WI. Three tumors were solid, whereas the other was solid and cystic. The normal ipsilateral ovary was identified in two patients of reproductive ages, but not in two postmenopausal patients. Tumors in two patients presented with acute abdomen were complicated by hemorrhage. All three tumors evaluated on DWI showed high intensities. Contrast-enhanced images of MRI and CT showed homogeneous enhancement as the same degree as the myometrium. On CT, one tumor contained punctate calcifications. FDG-PET/CT showed moderate FDG accumulation. Conclusion Wolffian tumors may be typically solid extraovarian tumors occasionally associated with cysts and calcifications. Although they are benign, they mimic malignancy due to high intensities on DWI and increased FDG accumulation.

Prediction of long-term prognosis over ten years in ER-positive HER2-negative early-stage breast cancer using 18F-FDG PET/CT before treatment.

e12542 Background: Although ER-positive, HER2-negative early-stage breast cancer is considered to have a relatively good prognosis, it is known to occur long-term recurrence for more than 10 years. 18F-FDG PET/CT has been reported to be useful in predicting short-term recurrence of breast cancer (2-5 years), but its correlation with long-term prognosis over ten years in ER-positive HER2-negative breast cancer is not clear. In the present study, we examined whether tumor FDG accumulation of pre-treatment PET/CT can be a predictor of long-term overall survival (OS) in ER-positive, HER2-negative early-stage breast cancer patients. Methods: Of 639 primary breast cancer patients treated at our institution between January 2007 and May 2010, 332 patients with stage 2 or less and ER-positive HER2-negative tumors who were able to confirm whether or not they had recurred at ten years postoperatively were included in the study. The impact of patients' characteristics, tumor background, and tumor FDG accumulation of pretreatment PET/CT image on OS was investigated using Cox regression analysis. P < 0.05 was considered to be a statistically significant difference. Results: There were 33 (9.9%) recurrences and 13 (3.9%) deaths during a median observation period of 121 months. Univariate analysis showed that tumor SUVmax / FDG accumulation in lymph nodes / stage / N category / diameter of invasion / nuclear grade were candidate predictors of OS. Multivariate analysis revealed that SUVmax (Hazzard ratio 1.36 [95% CI 1.13-1.63], P < 0.001) was the only predictor of OS. Conclusions: In patients with ER-positive HER2-negative early-stage breast cancer, tumor SUVmax on pretreatment PET/CT was the only independent predictor of OS.

Involvement of cancer-derived EMT cells in the accumulation of 18F-fluorodeoxyglucose in the hypoxic cancer microenvironment

A high rate of glycolysis, one of the most common features of cancer, is used in positron emission tomography (PET) imaging to visualize tumor tissues using 18F-fluorodeoxyglucose (18F-FDG). Heterogeneous intratumoral distribution of 18F-FDG in tissues has been established in some types of cancer, and the maximum standardized uptake value (SUVmax) has been correlated with poor prognosis. However, the phenotype of cells that show high 18F-FDG accumulation in tumors remains unknown. Here, we combined quantitative micro-autoradiography with fluorescence immunohistochemistry to simultaneously visualize 18F-FDG distribution, the expression of multiple proteins, and hypoxic regions in the cancer microenvironment of a human A431 xenograft tumor in C.B-17/Icr-scid/scid mice. We found that the highest 18F-FDG accumulation was in cancer-derived cells undergoing epithelial-mesenchymal transition (EMT) in hypoxic regions, implicating these regions as a major contributor to increased glucose metabolism, as measured by 18F-FDG-PET.

Characteristics of Benign Adrenocortical Adenomas with 18F-FDG PET Accumulation.

Introduction: Although 18F-FDG PET was originally developed to evaluate benign and malignant tumors, the frequency of detection of benign adrenocortical adenomas showing FDG-PET accumulation has increased. However, the details of FDG-PET-accumulated benign adrenocortical adenomas have not been elucidated. Methods: To elucidate the pathophysiology of FDG-PET-positive cortisol-producing adrenal tumors, we performed clinicopathological and genetic analyses of adrenocortical adenomas examing FDG-PET in 30 operated patients with unilateral cortisol-producing adrenal tumors (26 adrenal adenomas and 4 adrenal cancers). Results: All adrenocortical carcinomas and 17/26 (65%) benign adrenocortical adenomas showed high FDG accumulation (SUVmax ≥ 3). In adrenocortical adenomas with high FDG accumulation (SUVmax ≥ 3), SUVmax showed a positive correlation with the CT Hounsfield units. A higher SUVmax showed a clear black adenoma appearance with predominantly compact cells, which exhibited high T1 and T2 signals, a lack of signal drop on out-of-phase imaging on MRI, and less accumulation on 131-I adsterol scintigraphy. Furthermore, RNA-sequencing analysis revealed significant increases in the lysosomal and autophagy pathways and metabolic pathways, including glycolysis through glucose transporter (GLUT) 1 and 3, in black adenomas with high-level FDG accumulation. Discussion: A black adenoma is blackish due to lipofuscin, which accumulates as a result of damaged mitochondria or proteins that escape lysosomal degradation or autophagy. Since FDG in PET is taken up via GLUTs, alteration of the intracellular metabolic dynamics associated with mitochondrial damage in black adenomas may increase PET accumulation. Conclusion: Black adrenal adenomas should be considered with adrenal tumors showing PET accumulation and low lipid contents.

PET/MR imaging for the evaluation of cervical cancer during pregnancy

Background Malignancy during pregnancy is increasing, and the most common type of malignancy is uterine cervical cancer. When planning the treatment of cervical cancer, it is important to look for signs of metastasis before surgery, especially metastasis to the lymph nodes. In this report, we assessed the diagnostic value of positron emission tomography/magnetic resonance imaging (PET/MRI) for evaluating cervical cancer propagation before surgery, with a focus on pregnant women. Case presentation 18F Fluorodeoxyglucose (FDG)-PET/MRI was performed in seven pregnant cervical cancer patients (28–34 years old) at 9–18 gestational weeks. In case #5, a second PET/MRI was performed at 24 gestational weeks. Of seven FDG-PET/MRI examination series in six cases (cases #1–6), FDG-PET/MR imaging could detect cervical tumors with abnormal FDG accumulation; these tumors were confirmed with a standardized uptake value max (SUV max) titer of 4.5–16. A second PET/MRI examination in case #5 revealed the same SUV max titer as the first examination. In these six imaging series (cases #1–5), there were no signs of cancer metastasis to the parametrium and lymph nodes. However, in case #6, abnormal FDG accumulation in the left parametrial lymph nodes was also detectable. Pathological examination showed lymph node metastasis in case #6. In case #7, PET/MRI could not detect any abnormal FDG accumulation in the cervix and other sites. Cone biopsy demonstrated only micro-invasive squamous cell carcinoma. After treatment for cervical cancer, all seven patients have had no recurrence of disease within the follow-up period (2.8–5.6 years), and their children have developed appropriately. Conclusion PET/MRI is an effective imaging tool to evaluate cervical cancer progression in pregnancy.