4'-[甲基-(11)C]-硫代胸腺嘧啶摄取与Ki-67免疫组化及新诊断神经胶质瘤患者肿瘤分级的相关性，并与(11)C-蛋氨酸摄取作比较。
Correlation of 4'-[methyl-(11)C]-thiothymidine uptake with Ki-67 immunohistochemistry and tumor grade in patients with newly diagnosed gliomas in comparison with (11)C-methionine uptake.
作者信息
Tanaka Kenichi, Yamamoto Yuka, Maeda Yukito, Yamamoto Hiroyuki, Kudomi Nobuyuki, Kawai Nobuyuki, Toyohara Jun, Nishiyama Yoshihiro
机构信息
Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan.
Department of Medical Physics, Faculty of Medicine, Kagawa University, Kita-gun, Kagawa, Japan.
出版信息
Ann Nucl Med. 2016 Feb;30(2):89-96. doi: 10.1007/s12149-015-1035-x. Epub 2015 Oct 28.
OBJECTIVE
A novel radiopharmaceutical, 4'-[methyl-(11)C]thiothymidine ((11)C-4DST), has been developed as an in vivo cell proliferation marker based on the DNA incorporation method. The purpose of this study was to evaluate (11)C-4DST uptake in patients with newly diagnosed glioma and to correlate the results with proliferative activity and tumor grade, in comparison with L-[methyl-(11)C]-methionine ((11)C-MET).
METHODS
Investigations of (11)C-4DST and (11)C-MET PET/CT were performed retrospectively in 23 patients with newly diagnosed glioma. The maximum standardized uptake value (SUVmax) for tumor (T) and the mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. Metabolic tumor volume (MTV) was defined as the volume with a threshold of 40% of the SUVmax. Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens.
RESULTS
Of 23 gliomas examined, (11)C-4DST PET/CT and (11)C-MET PET/CT detected 20 and 22, respectively. Linear regression analysis between (11)C-4DST and (11)C-MET indicated a weak correlation for SUVmax (r = 0.54, P < 0.008), for T/N ratio (r = 0.56, P < 0.006), and for MTV (r = 0.60, P < 0.003). Linear regression analysis indicated a weak correlation between (11)C-4DST and Ki-67 index for SUVmax (r = 0.46, P < 0.03), for T/N ratio (r = 0.43, P < 0.05), and for MTV (r = 0.68, P < 0.001) and between (11)C-MET MTV and Ki-67 index (r = 0.43, P < 0.04). Using (11)C-4DST, there was a significant difference in SUVmax between grades II and IV (P < 0.03) and in MTV between grades II and IV (P < 0.009) and grades III and IV (P < 0.02). Using (11)C-MET, there was a significant difference in SUVmax (P < 0.009) and T/N ratio (P < 0.02) between grades II and IV and in MTV between grades II and IV (P < 0.03) and grades III and IV (P < 0.02).
CONCLUSION
(11)C-4DST PET/CT is feasible for imaging of brain gliomas, as well as (11)C-MET PET/CT. Especially, it showed the highest correlation coefficient between (11)C-4DST MTV and Ki-67 index in newly diagnosed gliomas.
目的
一种新型放射性药物4'-[甲基-(11)C]硫代胸腺嘧啶((11)C-4DST)已被开发出来，作为基于DNA掺入法的体内细胞增殖标志物。本研究的目的是评估初诊胶质瘤患者对(11)C-4DST的摄取情况，并将结果与增殖活性和肿瘤分级相关联，同时与L-[甲基-(11)C]-蛋氨酸((11)C-MET)进行比较。
方法
对23例新诊断的胶质瘤患者进行(11)C-4DST和(11)C-MET PET/CT检查的回顾性研究。计算肿瘤(T)的最大标准化摄取值(SUVmax)和对侧正常半球(N)的平均SUV，并确定肿瘤与正常组织的比值(T/N)。代谢肿瘤体积(MTV)定义为SUVmax阈值为40%时的体积。在组织标本中评估Ki-67指数所指示的增殖活性。
结果
在23例检查的胶质瘤中，(11)C-4DST PET/CT和(11)C-MET PET/CT分别检测到20例和22例。(11)C-4DST和(11)C-MET之间的线性回归分析表明，SUVmax(r = 0.54，P < 0.008)、T/N比值(r = 0.56，P < 0.006)和MTV(r = 0.60，P < 0.003)之间存在弱相关性。线性回归分析表明，(11)C-4DST与Ki-67指数在SUVmax(r = 0.46，P < 0.03)、T/N比值(r = 0.43，P < 0.05)和MTV(r = 0.68，P < 0.001)之间存在弱相关性，(11)C-MET MTV与Ki-67指数之间(r = 0.43，P < 0.04)也存在弱相关性。使用(11)C-4DST时，II级和IV级之间的SUVmax有显著差异(P < 0.03)，II级和IV级之间以及III级和IV级之间的MTV有显著差异(P < 0.009和P < 0.02)。使用(11)C-MET时，II级和IV级之间的SUVmax(P < 0.009)和T/N比值(P < 0.02)有显著差异，II级和IV级之间以及III级和IV级之间的MTV有显著差异(P < 0.03和P < 0.02)。
结论
(11)C-4DST PET/CT对脑胶质瘤成像可行，(11)C-MET PET/CT也可行。特别是，在新诊断的胶质瘤中，(11)C-4DST MTV与Ki-67指数之间的相关系数最高。
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