Correlation of bone marrow FDG uptake with systemic inflammation in patients with newly diagnosed endometrial cancer

Introduction: To clarify the relationship between FDG uptake of bone marrow and systemic inflammation in patients with newly diagnosed endometrial cancer.

Methods: A total of 119 patients with untreated endometrial cancer underwent FDG PET/CT. For bone marrow FDG uptake, the mean standardized uptake value (SUVmean) of the 5 vertebrae (T11-12 and L3-L5) was measured and averaged (bone marrow SUV). The bone marrow-to-liver ratio (BLR) was calculated by dividing the bone marrow SUV by the SUVmean of the normal liver. FDG PET parameters were correlated with white blood cell count, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR), and C-reactive protein (CRP), albumin and hemoglobin levels. They were also correlated with the Glasgow prognostic score (GPS) and FIGO stage.

Results: Bone marrow SUV and BLR showed significant positive correlations with white blood cell count, NLR, and CRP level and significant negative correlations with albumin level. BLR also showed a significant positive correlation with PLR. Significant differences in bone marrow SUV or BLR were noted according to GPS. No significant differences in bone marrow SUV and BLR were apparent according to FIGO stage.

Conclusions: Pre-treatment FDG PET/CT in patients with newly diagnosed endometrial cancer may provide information on host systemic inflammation as assessed by bone marrow FDG uptake.