title: 18F-FDG PET/CT imaging factors that predict ischaemic stroke in cancer patients.
abstract: OBJECTIVE
  18F-FDG PET/CT can acquire both anatomical and functional images in a single session. We investigated which factors of18F-FDG PET/CT imaging have potential as biomarkers for an increased risk of ischaemic stroke in cancer patients.
  
  
  METHODS
  From among cancer patients presenting with various neurological symptoms and hemiparesis, 134 were selected as eligible for this retrospective analysis. A new infarct lesion on brain MRI within 1 year of FDG PET/CT defined future ischaemic stroke. The target-to-background ratio (TBR) of each arterial segment was used to define arterial inflammation on PET imaging. Abdominal obesity was defined in terms of the area and proportion of visceral adipose tissue (VAT), subcutaneous adipose tissue and total adipose tissue (TAT) on a single CT slice at the umbilical level.
  
  
  RESULTS
  Ischaemic stroke confirmed by MRI occurred in 30 patients. Patients with stroke had higher TBRs in the carotid arteries and abdominal aorta (P < 0.001) and a higher VAT proportion (P = 0.021) and TAT proportion (P = 0.041) than patients without stroke. Multiple logistic regression analysis showed that TBRs of the carotid arteries and abdominal aorta, VAT and TAT proportions, and the presence of a metabolically active tumour were significantly associated with future ischaemic stroke. Combining PET and CT variables improved the power for predicting future ischaemic stroke.
  
  
  CONCLUSIONS
  Our findings suggest that arterial FDG uptake and hypermetabolic malignancy on PET and the VAT proportion on CT could be independent predictors of future ischaemic stroke in patients with cancer and could identify those patients who would benefit from medical treatment.
authors.affiliation: Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Jahae
authors.initials: J
authors.lastname: Kim
authors.affiliation: Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea. ckhchoikang@hanmail.net.|Department of Neurology, Chonnam National University Hwasun Hospital, 322 Seoyang-ro, Hwasun-eup, Hwasun-gun, Jeollanam-do, 58128, Republic of Korea. ckhchoikang@hanmail.net.
authors.forename: Kang-Ho
authors.initials: KH
authors.lastname: Choi
authors.affiliation: Department of Nuclear Medicine, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Ho-Chun
authors.initials: HC
authors.lastname: Song
authors.affiliation: Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Joon-Tae
authors.initials: JT
authors.lastname: Kim
authors.affiliation: Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Man-Seok
authors.initials: MS
authors.lastname: Park
authors.affiliation: Cerebrovascular Center, Chonnam National University Hospital, Gwangju, Korea.
authors.forename: Ki-Hyun
authors.initials: KH
authors.lastname: Cho
mesh_terms: D000368:Aged; D015984:Causality; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D000072078:Positron Emission Tomography Computed Tomography / Q000706:statistics & numerical data*; D015995:Prevalence; D011379:Prognosis; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D012680:Sensitivity and Specificity; D020521:Stroke / Q000000981:diagnostic imaging* / Q000453:epidemiology*
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: Adipose tissue; Cancer; PET/CT; Predictor; Stroke