Evolutionary dynamics at the tumor edge reveal metabolic imaging biomarkers
Juan Jiménez-Sánchez, Jesús J. Bosque, G.A. Jiménez Londoño, David Molina-García, Alvaro A. Martinez, Julián Pérez-Beteta, Carmen Ortega-Sabater, Antonio Francisco Honguero Martínez, Ana María García Vicente, Gabriel F. Calvo, Víctor M. Pérez‐García
Abstract
Significance Through the use of different in silico modeling approaches capturing tumor heterogeneity, we postulated that areas of high metabolic activity would shift toward the periphery as tumors become more aggressive. To confirm the hypothesis and provide clinical value for the finding, we collected 18 F-FDG PET images of breast cancers and non–small-cell lung cancers, where we measured the distance from the point of maximum activity to the tumor centroid, normalizing it by a surrogate of the volume. The metric, NHOC, showed higher prognostic value than other classical PET-based metabolic biomarkers used in oncology, evidencing that the shift of the hotspot of activity from the center of the tumor to its periphery correlates with a poor prognosis.