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A phase II clinical trial to investigate the effect of pioglitazone on 18F-FDG uptake in malignant lesions

Overview of attention for article published in EJNMMI Research, September 2015
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Title
A phase II clinical trial to investigate the effect of pioglitazone on 18F-FDG uptake in malignant lesions
Published in
EJNMMI Research, September 2015
DOI 10.1186/s13550-015-0128-9
Pubmed ID
Authors

Yeon-Hee Han, Seong Young Kwon, Jeonghun Kim, Chang Ju Na, Sehun Choi, Jung-Joon Min, Hee-Seung Bom, Young-Chul Kim, In-Jae Oh, Han-Jung Chae, Seok Tae Lim, Myung-Hee Sohn, Hwan-Jeong Jeong

Abstract

We found that (18)F-2-fluoro-2-deoxy-D-glucose ((18)F-FDG) uptake in malignant lesion was enhanced, and it was decreased in the inflammatory lesion after the use of peroxisome proliferator activated receptor-γ (PPAR-γ) agonist in our previous preclinical study. The purpose of this study was to investigate the effect of PPAR-γ agonist on malignant lesions in clinical (18)F-FDG positron emission tomography/computed tomography (PET/CT) imaging. Forty-three patients were enrolled in this prospective study. We received the approval for the investigator-initiated trials for a phase II human clinical trial from the Korean Food and Drug Administration. On the first day, (18)F-FDG PET/CT images were acquired from patients without administration of pioglitazone (PIO), which is a PPAR-γ agonist. On the next day, (18)F-FDG PET/CT images were acquired once again from the same patients after administration of PIO. We measured the (18)F-FDG uptake in malignant lesions or inflammatory lesions from two (18)F-FDG PET/CT images. Four different PET parameters were used to compare between the two studies: SUVmax, SUVmean, average activity over 30 % of the isocontour (isocontour, Bq/mL), and isocontour-mediastinal activity (Bq/mL). Additionally, we classified the patients into two groups: the responder or non-responder group according to the presence of PIO effect on skeletal muscle. Furthermore, PET parameters of malignant lesions were analyzed based on the type of malignancy and were compared with those of inflammatory lesions. All four PET parameters of malignant lesions in the responder group showed increasing patterns after the use of PIO. In the subgroup analysis, the similar pattern was observed in gastrointestinal cancer. In hepatobiliary and pancreatic cancer, SUVmean and isocontour showed statistically significant increase in the presence of PIO. On the other hand, in the non-responder group, all four PET parameters showed decreasing patterns in both malignant and inflammatory lesions after the use of PIO. There was no statistically significant difference in PET parameters of malignant lesions in the non-responder group. In this study, we found that PIO had the potential to increase (18)F-FDG uptake of malignant lesions in the patients who showed PIO effect on skeletal muscle. Contrary to our preclinical studies, clinical results had limitations to evaluate malignant lesions in non-responder group. Further larger-scale studies are necessary to elucidate the potential role of PIO on (18)F-FDG uptake in malignant or inflammatory lesions. The test for safety and effectiveness of the new efficacy of Pioglitazone to diagnose the malignant tumor and inflammation in F-18 FDG positron emission tomography (PET) study, 12029.

Mendeley readers

The data shown below were compiled from readership statistics for 10 Mendeley readers of this research output. Click here to see the associated Mendeley record.

Geographical breakdown

Country Count As %
Unknown 10 100%

Demographic breakdown

Readers by professional status Count As %
Other 2 20%
Student > Master 2 20%
Student > Ph. D. Student 1 10%
Student > Bachelor 1 10%
Researcher 1 10%
Other 1 10%
Unknown 2 20%
Readers by discipline Count As %
Medicine and Dentistry 3 30%
Immunology and Microbiology 1 10%
Agricultural and Biological Sciences 1 10%
Biochemistry, Genetics and Molecular Biology 1 10%
Chemistry 1 10%
Other 0 0%
Unknown 3 30%