Ito Kimiteru, Yokoyama Junkichi, Miyata Yoko, Toyohara Jun, Okasaki Momoko, Minamimoto Ryogo, Morooka Miyako, Ishiwata Kiichi, Kubota Kazuo
aDepartment of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine bDepartment of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine cResearch Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology dDepartment of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
Nucl Med Commun. 2015 Mar;36(3):219-25. doi: 10.1097/MNM.0000000000000241.
We prospectively compared the diagnostic value of PET/computed tomography (CT) findings using the tracers 4'-[methyl-11C]-thiothymidine (11C-4DST) and 2-deoxy-2-18F-fluoro-D-glucose (18F-FDG) in patients with head and neck squamous cell carcinoma (HNSCC).
Thirty-eight patients with advanced HNSCC underwent 11C-4DST PET/CT and 18F-FDG PET/CT before treatment. Maximum standardized uptake values (SUVmax) were measured for both PET/CT studies; in addition, total lesion glycolysis (TLG) of 18F-FDG PET/CT and total lesion proliferation (TLP) of 11C-4DST PET/CT were measured. Absolute TLG and TLP values as well as values with various SUV thresholds were measured. All patients were followed up for 13.5±7.5 months (mean±SD) to monitor recurrence.
A statistically significant correlation was observed between the primary tumor SUVmax for 11C-4DST PET/CT and 18F-FDG PET/CT (r=0.46, P<0.01). TLP values with SUV thresholds strongly correlated with TLG values relative to the same thresholds (r=0.60-0.92, P<0.001). Nine of the 38 patients with post-treatment recurrence were identified. Receiver operating characteristic curves for TLG3.0 and TLP2.5 showed the highest prognostic ability for recurrence; the sensitivity and specificity of TLG3.0 were 89 and 72%, respectively, and the sensitivity and specificity of TLP2.5 were 89 and 55%, respectively.
In patients with advanced HNSCC, the TLP of 11C-4DST PET/CT strongly correlated with the TLG of 18F-FDG PET/CT. Although there were no large differences between these values, the receiver operating characteristic curves of the absolute TLG had slightly better prognostic ability for recurrence.
我们前瞻性地比较了使用示踪剂4'-[甲基-11C]-硫代胸腺嘧啶核苷（11C-4DST）和2-脱氧-2-18F-氟-D-葡萄糖（18F-FDG）的PET/计算机断层扫描（CT）检查结果对头颈部鳞状细胞癌（HNSCC）患者的诊断价值。
38例晚期HNSCC患者在治疗前接受了11C-4DST PET/CT和18F-FDG PET/CT检查。对两项PET/CT检查均测量了最大标准化摄取值（SUVmax）；此外，还测量了18F-FDG PET/CT的总病灶糖酵解（TLG）和11C-4DST PET/CT的总病灶增殖（TLP）。测量了绝对TLG和TLP值以及具有不同SUV阈值的值。所有患者均随访13.5±7.5个月（均值±标准差）以监测复发情况。
观察到11C-4DST PET/CT和18F-FDG PET/CT的原发肿瘤SUVmax之间存在显著的统计学相关性（r = 0.46，P < 0.01）。具有SUV阈值的TLP值与相对于相同阈值的TLG值高度相关（r = 0.60 - 0.92，P < 0.001）。38例治疗后复发的患者中有9例被识别出来。TLG3.0和TLP2.5的受试者工作特征曲线显示出对复发的最高预后能力；TLG3.0的敏感性和特异性分别为89%和72%，TLP2.5的敏感性和特异性分别为89%和55%。
在晚期HNSCC患者中，11C-4DST PET/CT的TLP与18F-FDG PET/CT的TLG高度相关。尽管这些值之间没有很大差异，但绝对TLG的受试者工作特征曲线对复发的预后能力略好。
