A new study presented at the 38th Annual Congress of the European Society of Nuclear Medicine (EANM’25) shows that high metabolic activity of visceral fat may be associated with more aggressive forms of endometrial cancer. The results indicate that not only the amount of visceral fat, but above all its biological activity can influence the aggressiveness of the disease.

The researchers, from Haukeland University Hospital and the University of Bergen, examined PET/CT scans of 274 women with endometrial cancer. The glucose uptake in visceral fat was measured as an indicator of its metabolic activity. Women with higher metabolic activity often had advanced disease stages and lymph node metastases. Interestingly, there was no strong association between the amount of visceral fat and its metabolic activity, suggesting that the biological activity of the fat plays a bigger role than its volume.

The study suggests that chronic inflammation in visceral fat promotes the release of cytokines and fatty acids that can affect tumor growth and the body’s immune defenses. In addition, insulin resistance, triggered by inflammation, as well as signaling molecules such as adipokines and the interactions between adipose tissue and tumor cells could promote the spread of cancer, especially to the lymph nodes.

Although the measurement of visceral lipid metabolism activity by PET/CT is not yet suitable for routine clinical use due to technical challenges and variable signal strength, future developments such as standardized imaging analyses, advanced quantitative PET techniques and artificial intelligence could help to better identify high-risk patients, optimize treatment decisions and monitor disease progression.

The researchers plan to further refine the measurement methods, improve accuracy through AI-assisted segmentation, and investigate links between visceral fat metabolism and circulating biomarkers such as cytokines and hormones. The results could improve the diagnosis and treatment of endometrial cancer in the long term.

Source: European Association of Nuclear Medicine

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