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The clinical significance of physiologic Fluorine-18-fluorodeoxyglucose ( 18 F-FDG) intestinal uptake (IU) based on the predicted link with gut microbiota dysbiosis and inflammatory cytokine production was investigated in a cohort of breast cancer patients. A total of 114 patients were visually classified into the lower or higher IU group. The maximum and mean standardized uptake values of total bowel (TB SUV max  and TB SUV mean ) were measured. The gut microbial abundance of the  Citrobacter  genus of the Enterobacteriaceae family showed a significant positive correlation with TB SUV max  and TB SUV mean  ( q  = 0.021 and  q  = 0.010). The unclassified Ruminococcaceae showed a significant negative correlation with TB SUV max  ( q  = 0.010). The level of tumor necrosis factor alpha (TNF-α) was significantly increased in the high IU group ( p  = 0.017). The TNF-α levels showed a significant positive correlation with TB SUV max  ( rho  = 0.220 and  p  = 0.018) and TB SUV mean  ( rho  = 0.250 and  p  = 0.007). Therefore, our findings suggest that the physiologic intestinal uptake may reflect subclinical inflammation and differences in the composition of the gut microbiome in breast cancer patients.

Physiologic intestinal 18F-FDG uptake is associated with alteration of gut microbiota and proinflammatory cytokine levels in breast cancer