FDG-PET/CT imaging in assessing cancer-induced cachexia

Purpose of reviewCachexia, and cancer-induced cachexia in particular, pose a significant clinical challenge, given its complex etiology, late diagnosis and limited treatment options available today. With advances in precision oncology and systemic metabolic assessment, this review explores the potential of [¹⁸F]fluorodeoxyglucose positron emission tomography combined with computed tomography ([¹⁸F]FDG-PET/CT) - already integral to cancer patient management - to assess cachexia-related metabolic alterations beyond tumor detection.Recent findingsGrowing evidence suggests that [¹⁸F]FDG-PET/CT can capture early metabolic dysfunction in cachexia-affected tissues (e.g., muscle, adipose tissue, liver and heart), often preceding overt weight loss. These metabolic shifts may serve as novel biomarkers for early identification and monitoring. Integrating PET-derived data with automated CT-based body composition analysis could provide a more holistic view of systemic metabolic derangements. However, current evidence relies largely on retrospective or heterogeneous studies.SummaryProspective trials in well defined patient populations are needed to validate PET/CT imaging for the management of patients with cachexia. If proven effective, this approach could expand the role of PET/CT from tumor-centric imaging to a broader metabolic assessment platform, thus, enhancing supportive care in oncology.