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Imaging of proliferation with 18F-FLT PET/CT versus 18F-FDG PET/CT in non-small-cell lung cancer

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Abstract

Purpose

To compare the diagnostic efficacies of 18F-FLT and 18F-FDG PET/CT in non-small-cell lung cancer (NSCLC), focusing on the correlation between FLT and FDG tumour uptake and tumour cell proliferation as indicated by the cyclin D1 labelling index.

Methods

A total of 31 patients with NSCLC underwent FLT and FDG PET/CT scanning followed by surgery. PET/CT images were compared with the pathology. Tumour cell proliferation was assessed by cyclin D1 immunohistochemistry.

Results

The sensitivities of FLT and FDG PET/CT for the primary lesion were 74% and 94%, respectively (p=0.031). For N staging, 77% patients were correctly staged, 6% overstaged, 16% understaged by FLT, while the values for FDG were 77%, 16% and 6%, respectively. The sensitivity, specificity, accuracy, and positive predictive value with FLT for lymph nodes were 65%, 98%, 93% and 89%, respectively, and 85%, 84%, 84% and 52% with FDG (p<0.01).Tumour SUV of FLT was significantly correlated with the cyclin D1 labelling index (r=0.644; p<0.01), but the SUV of FDG was not significantly correlated (r=0.293; p>0.05).

Conclusion

In terms of N staging, FLT PET/CT resulted in understaging of more patients but overstaging of fewer patients, and for regional lymph nodes showed better specificity, accuracy and positive predictive value than FDG PET/CT in NSCLC. Tumour FLT uptake was correlated with tumour cell proliferation as indicated by the cyclin D1 labelling index, suggesting that further studies are needed to evaluate the use of FLT PET/CT for the assessment of therapy response to anticancer drugs.

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Acknowledgments

This work was supported by the Research Fund of Shandong Provincial Health Bureau of China (grant 2009HZ088), and by the Research Fund of Shandong Cancer Hospital and Institute (no. 2009-11).

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Authors and Affiliations

  1. Department of Thoracic Surgery, Shandong Cancer Hospital and Institute, Jinan, 250117, Shandong Province, People’s Republic of China

    Wenfeng Yang & Yongming Zhang

  2. Department of Nuclear Medicine, Shandong Cancer Hospital and Institute, Jinan, 250117, Shandong Province, People’s Republic of China

    Zheng Fu, Xiaorong Sun & Anqin Han

  3. Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Jiyan Road 440, Jinan, 250117, Shandong Province, People’s Republic of China

    Jinming Yu

  4. Department of Pathology, Shandong Cancer Hospital and Institute, Jinan, 250117, Shandong Province, People’s Republic of China

    Dianbin Mu

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  1. Wenfeng Yang
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Correspondence to Jinming Yu.

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Yang, W., Zhang, Y., Fu, Z. et al. Imaging of proliferation with 18F-FLT PET/CT versus 18F-FDG PET/CT in non-small-cell lung cancer. Eur J Nucl Med Mol Imaging 37, 1291–1299 (2010). https://doi.org/10.1007/s00259-010-1412-6

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  • DOI: https://doi.org/10.1007/s00259-010-1412-6

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