title: Modeling the relationship between fluorodeoxyglucose uptake and tumor radioresistance as a function of the tumor microenvironment.
abstract: High fluorodeoxyglucose positron emission tomography (FDG-PET) uptake in tumors has often been correlated with increasing local failure and shorter overall survival, but the radiobiological mechanisms of this uptake are unclear. We explore the relationship between FDG-PET uptake and tumor radioresistance using a mechanistic model that considers cellular status as a function of microenvironmental conditions, including proliferating cells with access to oxygen and glucose, metabolically active cells with access to glucose but not oxygen, and severely hypoxic cells that are starving. However, it is unclear what the precise uptake levels of glucose should be for cells that receive oxygen and glucose versus cells that only receive glucose. Different potential FDG uptake profiles, as a function of the microenvironment, were simulated. Predicted tumor doses for 50% control (TD50) in 2 Gy fractions were estimated for each assumed uptake profile and for various possible cell mixtures. The results support the hypothesis of an increased avidity of FDG for cells in the intermediate stress state (those receiving glucose but not oxygen) compared to well-oxygenated (and proliferating) cells.
authors.affiliation: The Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Jeho
authors.identifier: 0000-0001-5156-5878
authors.initials: J
authors.lastname: Jeong
authors.affiliation: The Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
authors.forename: Joseph O
authors.initials: JO
authors.lastname: Deasy
mesh_terms: D001786:Blood Glucose / Q000737:chemistry; D049109:Cell Proliferation; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000737:chemistry; D006801:Humans; D009369:Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000532:radiotherapy; D010100:Oxygen / Q000737:chemistry; D049268:Positron-Emission Tomography / Q000379:methods; D011336:Probability; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D059016:Tumor Microenvironment
chemical_list: D001786:Blood Glucose; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D005947:Glucose; D010100:Oxygen