Yamamoto Yuka, Nishiyama Yoshihiro, Ishikawa Shinya, Nakano Jun, Chang Sung Soo, Bandoh Shuji, Kanaji Nobuhiro, Haba Reiji, Kushida Yoshio, Ohkawa Motoomi
Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa 761-0793, Japan.
Eur J Nucl Med Mol Imaging. 2007 Oct;34(10):1610-6. doi: 10.1007/s00259-007-0449-7. Epub 2007 May 26.
The nucleoside analogue 3'-deoxy-3'-(18)F-fluorothymidine (FLT) has recently been introduced for imaging cell proliferation with positron emission tomography (PET). We prospectively evaluated whether FLT uptake reflects proliferative activity as indicated by the Ki-67 index in non-small cell lung cancer (NSCLC), in comparison with 2-deoxy-2-(18)F-fluoro-D-glucose (FDG).
A total of 18 patients with newly diagnosed NSCLC were examined with both FLT PET and FDG PET. PET imaging was performed at 60 min after each radiotracer injection. Tumour lesions were identified as areas of focally increased uptake, exceeding background uptake in the lungs. For semi-quantitative analysis, the maximum standardised uptake value (SUV) was calculated. Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens. Immunohistochemical findings were correlated with SUVs.
The sensitivity of FLT and FDG PET for the detection of lung cancer was 72% and 89%, respectively. Four of the five false-negative FLT PET findings occurred in bronchiolo-alveolar carcinoma. The mean FLT SUV was significantly lower than the mean FDG SUV. A significant correlation was observed between FLT SUV and Ki-67 index (r = 0.77; p < 0.0002) and for FDG SUV (r = 0.81; p < 0.0001).
The results of this preliminary study suggest that, compared with FDG, FLT may be less sensitive for primary staging in patients with NSCLC. Although FLT uptake correlated significantly with proliferative activity in NSCLC, the correlation was not better than that for FDG uptake.
核苷类似物3'-脱氧-3'-(18)F-氟胸苷（FLT）最近已被用于正电子发射断层扫描（PET）成像细胞增殖。我们前瞻性评估了与2-脱氧-2-(18)F-氟-D-葡萄糖（FDG）相比，FLT摄取是否反映了非小细胞肺癌（NSCLC）中Ki-67指数所指示的增殖活性。
共18例新诊断的NSCLC患者接受了FLT PET和FDG PET检查。在每次放射性示踪剂注射后60分钟进行PET成像。肿瘤病变被确定为摄取局部增加的区域，超过肺部背景摄取。进行半定量分析时，计算最大标准化摄取值（SUV）。在组织标本中评估Ki-67指数所指示的增殖活性。免疫组化结果与SUV相关。
FLT和FDG PET检测肺癌的敏感性分别为72%和89%。5例假阴性FLT PET结果中有4例发生在细支气管肺泡癌中。平均FLT SUV显著低于平均FDG SUV。FLT SUV与Ki-67指数之间观察到显著相关性（r = 0.77；p < 0.0002），FDG SUV也如此（r = 0.81；p < 0.0001）。
这项初步研究的结果表明，与FDG相比，FLT对NSCLC患者的初始分期可能不太敏感。尽管FLT摄取与NSCLC中的增殖活性显著相关，但这种相关性并不优于FDG摄取。
