TY - JOUR
T1 - Imaging gastric cancer with PET and the radiotracers 18F-FLT and 18F-FDG
T2 - A comparative analysis
AU - Herrmann, Ken
AU - Ott, Katja
AU - Buck, Andreas K.
AU - Lordick, Florian
AU - Wilhelm, Dirk
AU - Souvatzoglou, Michael
AU - Becker, Karen
AU - Schuster, Tibor
AU - Wester, Hans Jürgen
AU - Siewert, Jörg R.
AU - Schwaiger, Markus
AU - Krause, Bernd J.
PY - 2007/12/1
Y1 - 2007/12/1
N2 - In this pilot study, we evaluated 3′-deoxy-3′- 18F-fluorothymidine (FLT) PET for the detection of gastric cancer and compared the diagnostic accuracy with that of 18F-FDG PET. Methods: Forty-five patients (31 male and 14 female) with histologically proven locally advanced gastric cancer underwent attenuation-corrected whole-body 18F-FLT PET and 18F-FDG PET/CT (lowdose CT). 18F-FLT emission images were acquired on a full-ring PET scanner 45 min after the injection of 270-340 MBq of 18FFLT. 18F-FDG PET/CT was performed 60 min after the injection of 300-370 MBq of 18F-FDG. Mean standardized uptake values for 18F-FLT and 18F-FDG were calculated using circular ROIs (diameter, 1.5 cm) in the primary tumor manifestation site, in a reference segment of the liver, and in the bone marrow and were compared on a lesion-by-lesion basis. Results: According to the Lauren classification, 15 tumors (33%) were of the intestinal subtype and 30 (67%) of the nonintestinal subtype. 18F-FLT PET images showed high contrast for the primary tumor and proliferating bone marrow. In all patients (45/45), focal 18F-FLT uptake could be detected in the primary tumor. In contrast, 14 primary tumors were negative for 18F-FDG uptake, with lesional 18FFDG uptake lower than or similar to background activity. The mean standardized uptake value for 18F-FLT in malignant primaries was 6.0 ± 2.5 (range, 2.4-12.7). In the subgroup of 18F-FDG-positive patients, the mean value for 18F-FDG was 8.4 ± 4.1 (range, 3.8/19.0), versus 6.8 ± 2.6 for 18F-FLT (Wilcoxon test: P = 0.03). Comparison of mean 18F-FLT and 18F-FDG uptake in tumors with signet ring cells revealed no statistically significant difference between the tracers (6.2 ± 2.1 for 18F-FLT vs. 6.4 ± 2.8 for 18F-FDG; Wilcoxon test: P = 0.94). Conclusion: The results of this study indicate that imaging gastric cancer with the proliferation marker 18F-FLT is feasible. 18F-FLT PET was more sensitive than 18F-FDG PET, especially in tumors frequently presenting without or with low 18F-FDG uptake, and may improve early evaluation of response to neoadjuvant treatment.
AB - In this pilot study, we evaluated 3′-deoxy-3′- 18F-fluorothymidine (FLT) PET for the detection of gastric cancer and compared the diagnostic accuracy with that of 18F-FDG PET. Methods: Forty-five patients (31 male and 14 female) with histologically proven locally advanced gastric cancer underwent attenuation-corrected whole-body 18F-FLT PET and 18F-FDG PET/CT (lowdose CT). 18F-FLT emission images were acquired on a full-ring PET scanner 45 min after the injection of 270-340 MBq of 18FFLT. 18F-FDG PET/CT was performed 60 min after the injection of 300-370 MBq of 18F-FDG. Mean standardized uptake values for 18F-FLT and 18F-FDG were calculated using circular ROIs (diameter, 1.5 cm) in the primary tumor manifestation site, in a reference segment of the liver, and in the bone marrow and were compared on a lesion-by-lesion basis. Results: According to the Lauren classification, 15 tumors (33%) were of the intestinal subtype and 30 (67%) of the nonintestinal subtype. 18F-FLT PET images showed high contrast for the primary tumor and proliferating bone marrow. In all patients (45/45), focal 18F-FLT uptake could be detected in the primary tumor. In contrast, 14 primary tumors were negative for 18F-FDG uptake, with lesional 18FFDG uptake lower than or similar to background activity. The mean standardized uptake value for 18F-FLT in malignant primaries was 6.0 ± 2.5 (range, 2.4-12.7). In the subgroup of 18F-FDG-positive patients, the mean value for 18F-FDG was 8.4 ± 4.1 (range, 3.8/19.0), versus 6.8 ± 2.6 for 18F-FLT (Wilcoxon test: P = 0.03). Comparison of mean 18F-FLT and 18F-FDG uptake in tumors with signet ring cells revealed no statistically significant difference between the tracers (6.2 ± 2.1 for 18F-FLT vs. 6.4 ± 2.8 for 18F-FDG; Wilcoxon test: P = 0.94). Conclusion: The results of this study indicate that imaging gastric cancer with the proliferation marker 18F-FLT is feasible. 18F-FLT PET was more sensitive than 18F-FDG PET, especially in tumors frequently presenting without or with low 18F-FDG uptake, and may improve early evaluation of response to neoadjuvant treatment.
KW - FLT
KW - Gastric cancer
KW - PET
KW - Proliferation
UR - http://www.scopus.com/inward/record.url?scp=36849017355&partnerID=8YFLogxK
U2 - 10.2967/jnumed.107.044867
DO - 10.2967/jnumed.107.044867
M3 - Article
C2 - 18006614
AN - SCOPUS:36849017355
SN - 0161-5505
VL - 48
SP - 1945
EP - 1950
JO - Journal of Nuclear Medicine
JF - Journal of Nuclear Medicine
IS - 12
ER -