Dittmann Helmut, Dohmen Bernhard Matthias, Paulsen Frank, Eichhorn Kai, Eschmann Susanne Martina, Horger Marius, Wehrmann Manfred, Machulla Hans Juergen, Bares Roland
Department of Nuclear Medicine, Eberhard-Karls-University Tübingen, Tübingen, Germany.
Eur J Nucl Med Mol Imaging. 2003 Oct;30(10):1407-12. doi: 10.1007/s00259-003-1257-3. Epub 2003 Jul 26.
The nucleoside analogue 3'-deoxy-3'-[18F]fluorothymidine (FLT) has been introduced for imaging of tumour cell proliferation by positron emission tomography (PET). This study evaluated the use of FLT in patients with thoracic tumours prior to treatment. Whole-body FLT PET was performed in 16 patients with 18 tumours [17 thoracic tumours (nine non-small cell lung cancers, five oesophageal carcinomas, two sarcomas, one Hodgkin's lymphoma) and one renal carcinoma] before treatment. Fluorine-18 fluorodeoxyglucose (FDG) PET was performed for comparison except in those patients with oesophageal carcinoma. For semi-quantitative analysis, the average and maximum standardised uptake values (avgSUV and maxSUV, respectively) (FLT, 114+/-20 min p.i.; FDG, 87+/-8 min p.i.; 50% isocontour region of interest) was calculated. All 17 thoracic tumours and 19/20 metastases revealed significant FLT accumulation, resulting in easy delineation from surrounding tissue. The additional small grade 1 renal carcinoma was not detected with either FLT or FDG. In most lung tumours (avgSUV 1.5-8.2) and metastases, FLT showed intense uptake. However, one of two spinal bone metastases was missed owing to the high physiological FLT uptake in the surrounding bone marrow. Oesophageal carcinoma primaries (avgSUV 2.7-10.0) and occasional metastases showed particularly favourable tumour/non-tumour contrast. Compared with FDG, tumour uptake of FLT was lower (avgSUV, P=0.0006; maxSUV, P=0.0001), with a significant linear correlation (avgSUV, r2=0.45; maxSUV, r2=0.49) between FLT and FDG. It is concluded that FLT PET accurately visualises thoracic tumour lesions. In the liver and the bone marrow, high physiological FLT uptake hampers detection of metastases. On the other hand, FLT may be favourable for imaging of brain metastases owing to the low physiological uptake.
核苷类似物3'-脱氧-3'-[18F]氟胸苷（FLT）已被用于通过正电子发射断层扫描（PET）对肿瘤细胞增殖进行成像。本研究评估了FLT在胸部肿瘤患者治疗前的应用情况。在治疗前，对16例患有18个肿瘤的患者（17个胸部肿瘤[9例非小细胞肺癌、5例食管癌、2例肉瘤、1例霍奇金淋巴瘤]和1例肾癌）进行了全身FLT PET检查。除食管癌患者外，均进行了氟-18氟脱氧葡萄糖（FDG）PET检查以作比较。进行半定量分析时，计算了平均和最大标准化摄取值（分别为avgSUV和maxSUV）（FLT，注射后114±20分钟；FDG，注射后87±8分钟；50%等轮廓感兴趣区）。所有17个胸部肿瘤和19/20个转移灶均显示有明显的FLT积聚，从而易于与周围组织区分。另外的小的1级肾癌用FLT或FDG均未检测到。在大多数肺肿瘤（avgSUV 1.5 - 8.2）和转移灶中，FLT显示出强烈摄取。然而，由于周围骨髓中FLT的生理性摄取较高，两个脊柱骨转移灶中有一个被漏诊。食管癌原发灶（avgSUV 2.7 - 10.0）及偶尔的转移灶显示出特别良好的肿瘤/非肿瘤对比。与FDG相比，FLT的肿瘤摄取较低（avgSUV，P = 0.0006；maxSUV，P = 0.0001），FLT与FDG之间存在显著的线性相关性（avgSUV，r2 = 0.45；maxSUV，r2 = 0.49）。结论是，FLT PET能准确显示胸部肿瘤病变。在肝脏和骨髓中，生理性FLT摄取较高会妨碍转移灶的检测。另一方面，由于生理性摄取较低，FLT可能有利于脑转移灶的成像。
