Comparison of Positron Emission Tomography Using 2-[18F]-fluoro-2-deoxy-D-glucose and 3-deoxy-3-[18F]-fluorothymidine in Lung Cancer Imaging

Abstract

Background:The detection of solitary pulmonary nodules (SPNs) that may potentially develop into a malignant lesion is essential for early clinical interventions. However, grading classification based on computed tomography (CT) imaging results remains a significant challenge. The 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) positron emission tomography (PET)/CT imaging produces both false-positive and false-negative findings for the diagnosis of SPNs. In this study, we compared 18F-FDG and 3-deoxy-3-[18F]-fluorothymidine (18F-FLT) in lung cancer PET/CT imaging.Methods:The binding ratios of the two tracers to A549 lung cancer cells were calculated. The mouse lung cancer model was established (n = 12), and micro-PET/CT analysis using the two tracers was performed. Images using the two tracers were collected from 55 lung cancer patients with SPNs. The correlation among the cell-tracer binding ratios, standardized uptake values (SUVs), and Ki-67 proliferation marker expression were investigated.Results:The cell-tracer binding ratio for the A549 cells using the 18F-FDG was greater than the ratio using 18F-FLT (P < 0.05). The Ki-67 expression showed a significant positive correlation with the 18F-FLT binding ratio (r = 0.824, P < 0.01). The tumor-to-nontumor uptake ratio of 18F-FDG imaging in xenografts was higher than that of 18F-FLT imaging. The diagnostic sensitivity, specificity, and the accuracy of 18F-FDG for lung cancer were 89%, 67%, and 73%, respectively. Moreover, the diagnostic sensitivity, specificity, and the accuracy of 18F-FLT for lung cancer were 71%, 79%, and 76%, respectively. There was an obvious positive correlation between the lung cancer Ki-67 expression and the mean maximum SUV of 18F-FDG and 18F-FLT (r = 0.658, P < 0.05 and r = 0.724, P < 0.01, respectively).Conclusions:The 18F-FDG uptake ratio is higher than that of 18F-FLT in A549 cells at the cellular level. 18F-FLT imaging might be superior for the quantitative diagnosis of lung tumor tissue and could distinguish lung cancer nodules from other SPNs.

Usefulness of Positron Emission Tomography in Patients with Syphilis

“…[42] Takayasu's arteritis affected the aorta and its branches but might show a more focal and localized inhomogeneous pattern of FDG uptake and had a more aggressive clinical course. [4344] The localization of the increased metabolic activity seemed to be present in the ascending aorta in syphilitic aortitis, consistent with postmortem examinations. [23] The ascending aorta and transverse aortic arch were the most commonly affected blood vessels in syphilitic aortitis.…”

The value of 18F-FDG-PET/CT in the diagnosis of solitary pulmonary nodules

“…[ 24 – 28 ] Thus, 20 publications assessing the diagnostic performance of 18 F-FDG-PET/CT in SPNs were included. [ 15 – 17 , 29 – 45 ] One study involved 2 study groups [ 39 ] ; sufficient data were reported for each that they were treated as 2 independent studies. Finally, 21 studies from 20 publications were included.…”

Clinical value of 3'-deoxy-3'-[18F]fluorothymidine-positron emission tomography for diagnosis, staging and assessing therapy response in lung cancer

“…It has been a beneficial adjunct in characterisation of intermediate solitary lung nodules and pre-treatment detection and staging of distant metastases [8]. However, [ 18 F]FDG uptake is modulated by multiple signalling pathways, so is not selective enough to specifically assess changes in the cell proliferation rate. Moreover, a meta-analysis of [ 18 F]FDG in LC showed its extreme heterogeneity in LC in pulmonary areas with inflammations [9].…”

“…• [ 18 F]FLT has higher specificity than [ 18 F]FDG for diagnosing or staging lung cancer. • [ 18 F]FLT has lower sensitivity than [ 18 F]FDG for diagnosing or staging lung cancer. • [ 18 F]FLT has good predictive values for assessing response to radiotherapy or chemoradiotherapy.…”