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Clinical Investigations |
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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