Findings from Positron Emission Tomography-Computed Tomography with 18F-Fluorodeoxyglucose Uncover a Potential Marker of Nutritional Status in Cancer Patients: A Cross-Sectional Pilot Study.

BACKGROUND: Cancer patients often have altered nutritional status and periodically undergo imaging tests. We hypothesized that standard uptake values (SUV) by positron emission tomography-computed tomography (PET/CT) with 18 F-fluorodeoxyglucose (18F-FDG) could be associated with the nutritional status of cancer patients. MATERIALS AND METHODS: Adult cancer patients who underwent clinical evaluation and PET/CT with 18 F-FDG on the same day were included in a cross-sectional pilot study. The focus was on evaluating 18 F-FDG findings with regard to nutritional status, with an emphasis on liver SUVmean and tumor SUVmax. RESULTS: A total of 179 patients were evaluated. One hundred and three (57.5%) were classified as well-nourished, 54 (30.1%) as suspected/moderately malnourished, and 22 (12.2%) as severely malnourished. The median hepatic SUVmean was 2.29, with 1.87 corresponding to the 10th percentile. There was a significant difference between the severely malnourished (2.02) and well-nourished or suspected/moderately malnourished (2.36) patients. Severely malnourished patients were more likely to have a SUVmean < 1.87 (p = .035). The tumor SUVmax also was significantly higher in severely malnourished patients (p = .003). CONCLUSION: Cancer patients with severe malnutrition have lower values of hepatic SUVmean and higher values of tumor SUVmax in PET/CT with 18F-FDG when compared to well-nourished patients.

Critical analysis of factors affecting the efficiency of nutrition therapy teams.

BACKGROUND: Nutrition therapy (NT), defined as the provision of oral, enteral, or parenteral nutrition, should be considered a part of the holistic approach to patient care, while quality assessment of its practices is crucial. The present study aimed to identify variables capable of explaining the reason behind compliance of NTTs with the regulatory requirements. METHODS: A cross-sectional study focused on assessing the quality of nutritional therapy practices among NTTs who previously stated to be able to comply with requirements of the Brazilian law versus those who were not able to meet these demands. Hospitals were classified as A (teams that had previously reported to be able to meet the requirements) and B (those unable to comply with them). The study was approved by the ethics committees of all participant institutions. RESULTS: Twenty six hospitals met the inclusion criteria. The main hospital features, such as size, classification, service type, and percentage of hospitals providing NT were similar. Hospitals differed on the median number of patients undergoing NT per week: in group B (41.0; IR = 28.0-58.0) and group A (11.0; IR = 5.0-48.0) (p < 0.05), but there were no differences regarding personnel expertise. Both hospital groups had low quality control of the NT processes. CONCLUSION: Lack of quality assurance is responsible for the inadequate services in both type of institutions.