Description:
Background: Hypoxia-inducible factor (HIF)-1a plays a key role in hypoxic adaptation of tumor cells. Overexpressionof HIF-1a is associated with tumor aggressiveness and worse prognosis in several malignancies. Presumably, expressionof HIF-1a may be reflected by positron emission tomography with 2-deoxy-2 [fluorine-18] fluoro-D-glucose (18F-FDGPET). There are inconsistent data about relationships between FDG PET and HIF-1a.Purpose: To provide evident data about associations between maximum standardized uptake value (SUVmax) andHIF-1a expression in solid tumors.Material and Methods: MEDLINE, SCOPUS, and EMBASE databases were screened for relationships between SUVand HIF-1a up to August 2019. Overall, 21 studies with 1154 patients were identified. The following data were extractedfrom the literature: authors; year of publication; number of patients; and correlation coefficients.Results: Correlation coefficients between SUVmax and HIF-1a were in the range of 0.51–0.71. The pooled correlationcoefficient was 0.27 (95% confidence interval [CI] ¼ 0.14–0.41). Furthermore, correlation coefficients for some tumorentities were calculated. For this sub-analysis, data for primary tumors with >2 reports were included. The calculatedcorrelation coefficients in the analyzed subgroups were as follows: head and neck squamous cell carcinoma: q ¼ 0.25(95% CI ¼ 0.07–0.42); non-small lung cell cancer: q ¼ 0.27 (95% CI ¼ 0.14–0.67); uterine cervical cancer: q ¼ 0.09(95% CI ¼ 0.89–0.71); thymic tumors: q ¼ 0.39 (95% CI ¼ 0.04–0.58).Conclusion: SUVmax of FDG PET correlated weakly with expression of HIF-1a both in overall sample and tumorsubgroups. Therefore, FDG PET cannot be used for prediction of hypoxia in clinical practice