Relationship between sex hormones levels and 18F-FDG uptake by the ovaries in premenopausal woman

Kim, Tae Hee; Kim, Mi Ran; Jung, Yongsik; An, Young-Sil

doi:10.2478/raon-2019-0035

Abstract

Background

The study was conducted to evaluate the effect of sex hormones on F-18 fluorodeoxyglucose (¹⁸F-FDG) uptake by normal ovaries.

Patients and methods

A total of 197 premenopausal women were included in this study. Based on ¹⁸F-FDG positron emission tomography/computed tomography (PET/CT) images obtained from these subjects, the association of ovarian ¹⁸F-FDG uptake with levels of sex hormones, including estradiol, progesterone, testosterone, follicle-stimulating hormone, and luteinizing hormone was investigated. We also analysed the relationship between the menstrual cycle and ovarian ¹⁸F-FDG uptake.

Results

The highest ovarian ¹⁸F-FDG uptake occurred at 2 weeks after the onset of menstruation (median maximum standardized uptake value [SUVmax] = 3.40, median mean SUV [SUVmean] = 2.20), and the lowest ovarian ¹⁸F-FDG uptake was observed during the first week of the menstrual cycle (median SUVmax = 1.60, median SUVmean = 1.20). Ovarian ¹⁸F-FDG uptake was weakly positively correlated with progesterone levels (rho = 0.28, p < 0.001 for SUVmax, rho = 0.30, p < 0.001 for SUVmean), and this pattern was consistently observed in subjects in the follicular-phase group (rho = 0.29, p = 0.003 for both SUVmax and SUVmean) but not in subjects in the luteal-phase group.

Conclusions

Based on PET images, ovarian glucose metabolism in premenopausal women tended to increase slightly with increasing progesterone concentration.

References

Fletcher JW, Djulbegovic B, Soares HP, Siegel BA, Lowe VJ, Lyman GH, et al. Recommendations on the use of 18F-FDG PET in oncology. J Nucl Med 2008; 49: 480-508. doi: 10.2967/jnumed.107.047787
Open DOI Search in Google Scholar Back to article
Shreve PD, Anzai Y, Wahl RL. Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. Radiographics 1999; 19: 61-77; quiz 150-1. doi: 10.1148/radiographics.19.1.g99ja0761
Open DOI Search in Google Scholar Back to article
Rosenbaum SJ, Lind T, Antoch G, Bockisch A. False-positive FDG PET uptake-the role of PET/CT. Eur Radiol 2006; 16: 1054-65. doi: 10.1007/s00330-005-0088-y
Open DOI Search in Google Scholar Back to article
Israel O, Yefremov N, Bar-Shalom R, Kagana O, Frenkel A, Keidar Z, et al. PET/CT detection of unexpected gastrointestinal foci of 18F-FDG uptake: incidence, localization patterns, and clinical significance. J Nucl Med 2005; 46: 758-62.
Search in Google Scholar Back to article
Lerman H, Metser U, Grisaru D, Fishman A, Lievshitz G, Even-Sapir E. Normal and abnormal 18F-FDG endometrial and ovarian uptake in pre- and post-menopausal patients: assessment by PET/CT. J Nucl Med 2004; 45: 266-71.
Search in Google Scholar Back to article
Liu Y. Benign ovarian and endometrial uptake on FDG PET-CT: patterns and pitfalls. Ann Nucl Med 2009; 23: 107-12. doi: 10.1007/s12149-008-0227-z
Open DOI Search in Google Scholar Back to article
Cook GJ, Fogelman I, Maisey MN. Normal physiological and benign pathological variants of 18-fluoro-2-deoxyglucose positron-emission tomography scanning: potential for error in interpretation. Semin Nucl Med 1996; 26: 308-14. doi: 10.1016/S0001-2998(96)80006-7
Open DOI Search in Google Scholar Back to article
Nishizawa S, Inubushi M, Okada H. Physiological 18F-FDG uptake in the ovaries and uterus of healthy female volunteers. Eur J Nucl Med Mol Imaging 2005; 32: 549-56. doi: 10.1007/s00259-004-1703-x
Open DOI Search in Google Scholar Back to article
Kim SK, Kang KW, Roh JW, Sim JS, Lee ES, Park SY. Incidental ovarian 18F-FDG accumulation on PET: correlation with the menstrual cycle. Eur J Nucl Med Mol Imaging 2005; 32: 757-63. doi: 10.1007/s00259-005-1771-6
Open DOI Search in Google Scholar Back to article
Chiazze L, Jr., Brayer FT, Macisco JJ, Jr., Parker MP, Duffy BJ. The length and variability of the human menstrual cycle. JAMA 1968; 203: 377-80. doi: 10.1001/jama.1968.03140060001001
Open DOI Search in Google Scholar Back to article
Weir I. Spearman’s correlation. Statstutor, Mathematics Education Centre Loughborough University. 2016; 29. Available at: http://wwwstatstutoracuk/resources/uploaded/spearmanspdfAccessed.
Search in Google Scholar Back to article
Csapo AI, Pinto-Dantas CA. The effect of progesterone on the human uterus. Proc Natl Acad Sci U S A 1965; 54: 1069-76. doi: 10.1073/pnas.54.4.1069
Open DOI Search in Google Scholar Back to article
Widmaier EP, Raff H, Strang KT. Vander’s human physiology: the mechanisms of body functions. New York: McGraw-Hill Higher Education; 2008.
Search in Google Scholar Back to article
De Geyter C, De Geyter M, Huber PR, Nieschlag E, Holzgreve W. Progesterone serum levels during the follicular phase of the menstrual cycle originate from the crosstalk between the ovaries and the adrenal cortex. Hum Reprod 2002; 17: 933-9. doi: 10.1093/humrep/17.4.933
Open DOI Search in Google Scholar Back to article
Van Iten B. Estrogen and the Menstrual Cycle in Humans. Embryo Project Encyclopedia 2016. Available at: https://embryo.asu.edu/pages/estrogen-and-menstrual-cycle-humans
Search in Google Scholar Back to article
Broekmans FJ, Soules MR, Fauser BC. Ovarian aging: mechanisms and clinical consequences. Endocr Rev 2009; 30: 465-93. doi: 10.1210/er.2009-0006
Open DOI Search in Google Scholar Back to article
Kol S, Ben-Shlomo I, Ruutiainen K, Ando M, Davies-Hill TM, Rohan RM, et al. The midcycle increase in ovarian glucose uptake is associated with enhanced expression of glucose transporter 3. Possible role for interleukin-1, a putative intermediary in the ovulatory process. J Clin Invest 1997; 99: 2274-83. doi: 10.1172/JCI119403
Open DOI Search in Google Scholar Back to article
Balsara G, Hernandez E. The ovary: normal, physiologic changes, endometriosis, and metastatic tumors. Clinical Gynecologic Pathology. Philadelphia, PA: Saunders. 1995; 404-9.
Search in Google Scholar Back to article
Reed BG, Carr BR. The normal menstrual cycle and the control of ovulation. In: Feingold KR, Anawalt B, Boyce A, Chrousos G, Dungan K, Grossman A, et al, editors. Endotext [Internet] South Dartmouth (MA): MDText.com Inc.; 2000.
Search in Google Scholar Back to article
Zhu Z, Wang B, Cheng W, Cheng X, Cui R, Huo L, et al. Endometrial and ovarian F-18 FDG uptake in serial PET studies and the value of delayed imaging for differentiation. Clin Nucl Med 2006; 31: 781-7. doi: 10.1097/01. rlu.0000247261.82757.ea
Open DOI Search in Google Scholar Back to article