High metabolic characteristics of uterine fibroids in 18F-FDG PET/CT imaging and the underlying mechanisms

ObjectiveTo investigate the high metabolic characteristics of uterine fibroids in fluorine-18 fluorodeoxyglucose (F-18-FDG) PET/computed tomographic imaging and the underlying mechanisms.Materials and methodsA total of 47 patients with uterine fibroids who underwent PET/computed tomographic imaging and ultrasound examination from November 2011 to May 2015 were retrospectively analyzed. The characteristics of F-18-FDG uptake by uterine fibroids were analyzed and their correlations with age, menopause, menstrual cycle, hormone indexes, tumor markers as well as the number and maximum diameter of fibroids in ultrasound images were explored using univariate analysis and multivariate logistic regression analysis.Results(a) The total positive F-18-FDG uptake rate and maximum standardized uptake value (SUVmax) were 40.4% (19/47) and 4.382.57 (1.74-10.81), respectively, in patients with uterine fibroids; (b) univariate analysis showed that age, menopause, estrogen, follicle-stimulating hormone, luteinizing hormone as well as the number of fibroids were correlated positively with F-18-FDG uptake in uterine fibroids (P<0.05); and (c) multivariate logistic regression analysis showed that only the number of fibroids was meaningfully correlated with F-18-FDG uptake in uterine fibroids (odds ratio=30.000, P<0.05).ConclusionUterine fibroids have a higher positive F-18-FDG uptake rate and highly variable SUVmax. The SUVmax is especially higher in younger and premenopausal patients. Multiple fibroids play a decisive role in the positive F-18-FDG uptake rate possibly because of the quantitative to qualitative changes in the effects of estrogen on the proliferation of uterine fibroids.