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¹⁸F-FLT PET for Visualization of Laryngeal Cancer: Comparison with ¹⁸F-FDG PET

¹ PET Center, Groningen University Hospital, Groningen, The Netherlands
² Department of Surgical Oncology, Groningen University Hospital, Groningen, The Netherlands
³ Department of Otorhinolaryngology–Head and Neck Surgery, Groningen University Hospital, Groningen, The Netherlands
⁴ Department of Pathology and Laboratory Medicine, Groningen University Hospital, Groningen, The Netherlands

The feasibility of ¹⁸F-3'-fluoro-3'-deoxy-L-thymidine PET (FLT PET) for detecting laryngeal cancer was investigated and compared with ¹⁸F-FDG PET. Methods: Eleven patients diagnosed with or strongly suspected of having recurrent laryngeal cancer and 10 patients with histologically proven primary laryngeal cancer underwent attenuation-corrected ¹⁸F-FLT PET imaging 60 min after injection of a median of 213 MBq (range, 175–400 MBq) ¹⁸F-FLT and attenuation-corrected ¹⁸F-FDG PET imaging 90 min after injection of a median of 340 MBq (range, 165–650 MBq) ¹⁸F-FDG. All patients were staged by endoscopy and CT according to the Union Internationale Contre la Cancer TNM staging system. All patients underwent biopsy of the laryngeal area after imaging. Lesions seen on ¹⁸F-FDG PET and ¹⁸F-FLT PET were compared with histopathologic results. Mean SUVs, maximum SUVs, and tumor-to-nontumor (TNT) ratios were calculated for ¹⁸F-FLT and ¹⁸F-FDG. Wilcoxon nonparametric testing was used for comparison of ¹⁸F-FDG with ¹⁸F-FLT uptake. The Spearman correlation coefficient was used to correlate mean SUVs, maximum SUVs, and TNT ratios of ¹⁸F-FDG PET and ¹⁸F-FLT PET. Two-tailed P values < 0.05 were considered significant. Results: ¹⁸F-FDG PET and ¹⁸F-FLT PET detected laryngeal cancer correctly in 15 of 17 patients. One lesion judged as positive on ¹⁸F-FDG PET turned out to be normal tissue. Of 2 lesions judged as positive on ¹⁸F-FLT PET, 1 turned out to be inflammation and the other to be normal tissue. Maximum SUVs were 3.3 (range, 1.9–8.5) for ¹⁸F-FDG and 1.6 (range, 1.0–5.7) for ¹⁸F-FLT (P < 0.001). Mean SUVs were 2.7 (range, 1.5–6.5) for ¹⁸F-FDG and 1.2 (range, 0.8–3.8) for ¹⁸F-FLT (P < 0.001). TNT was 1.9 (range, 1.3–4.7) for ¹⁸F-FDG and 1.5 (range, 1.1–3.5) for ¹⁸F-FLT (P < 0.05). Conclusion: The numbers of laryngeal cancers detected with ¹⁸F-FLT PET and ¹⁸F-FDG PET were equal. In laryngeal cancer, the uptake of ¹⁸F-FDG is higher than that of ¹⁸F-FLT.

Key Words: ¹⁸F-FLT • ¹⁸F-FDG • recurrent laryngeal cancer • primary laryngeal cancer • PET

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