JNM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

First published online August 18, 2009, 10.2967/jnumed.109.065896
This Article
Right arrow Figures Only
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
jnumed.109.065896v1
50/9/1441    most recent
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Related articles in JNM
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Eckel, F.
Right arrow Articles by Buck, A. K.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Eckel, F.
Right arrow Articles by Buck, A. K.
Journal of Nuclear Medicine Vol. 50 No. 9 1441-1447
© 2009 by Society of Nuclear Medicine
doi: 10.2967/jnumed.109.065896

Clinical Investigation

Imaging of Proliferation in Hepatocellular Carcinoma with the In Vivo Marker 18F-Fluorothymidine

Florian Eckel*,1, Ken Herrmann*,2, Stefan Schmidt3, Claudia Hillerer2, Hinrich A. Wieder3, Bernd-Joachim Krause2, Tibor Schuster4, Rupert Langer5, Hans-Jürgen Wester2, Roland M. Schmid1, Markus Schwaiger2 and Andreas K. Buck2

1 Department of Internal Medicine II, Technische Universität München, Munich, Germany; 2 Department of Nuclear Medicine, Technische Universität München, Munich, Germany; 3 Department of Radiology, Technische Universität München, Munich, Germany; 4 Department of Medical Statistics, Technische Universität München, Munich, Germany; and 5 Department of Pathology, Technische Universität München, Munich, Germany

Correspondence: For correspondence or reprints contact: Ken Herrmann, Department of Nuclear Medicine, Technische Universität München, Ismaninger Strasse 22, D-81675 Munich, Germany. E-mail: ken.herrmann{at}tum.de

We determined the ability of PET with the thymidine analog 3'-deoxy-3'-18F-fluorothymidine (18F-FLT) to detect hepatocellular carcinoma (HCC). Methods: In this pilot study, 18F-FLT PET was performed in 18 untreated patients with clinically suspected HCC. Routine diagnostic procedures included ultrasound, MRI, or contrast-enhanced spiral CT of the upper gastrointestinal tract in all patients. At 45–60 min after the intravenous injection of approximately 270–340 MBq of 18F-FLT, emission and transmission scanning was performed with a high-resolution PET scanner. Tracer uptake in the tumor and surrounding liver tissue was evaluated semiquantitatively by calculation of mean and maximum standardized uptake values (SUVs). Results were correlated with those of the conventional imaging methods. Results: A total of 13 of 18 tumors (sensitivity, 72%; 95% confidence interval [CI], 47%–90%) showed focal 18F-FLT uptake higher than surrounding liver activity and were detectable as hot lesions. Five tumors were characterized as photopenic lesions or contained a mixture of hot and cold lesions exhibiting a comparable or lower 18F-FLT uptake than the surrounding liver tissue. When all lesions were considered, the mean 18F-FLT SUV was 7.8 (range, 2.5–11.1), and the maximum 18F-FLT SUV was 9.3 (range, 2.9–14.3). Histology and clinical follow-up revealed HCC in 16 patients and cholangiocarcinoma in 2 patients. In the subgroup of HCC, the sensitivity for tumor detection was 69% (11/16; 95% CI, 41%–89%). Correlation analysis demonstrated a significant positive relationship between the proliferation marker MIB-1 and the mean SUV (r = 0.66, P = 0.02). Survival analysis (Cox proportional hazards regression) for initial 18F-FLT uptake (mean and maximum SUVs) revealed increased hazard ratios (mean SUV, 1.20; maximum SUV, 1.12), but because of the small number of events, these results were not statistically significant. Conclusion: In this pilot study, HCC tumors showed a mixed uptake pattern for the in vivo proliferation marker 18F-FLT. A total of 69% of the HCC lesions showed 18F-FLT uptake higher than that of the surrounding liver tissue, whereas the remaining lesions were photopenic or contained a mixture of hot and cold lesions. High initial 18F-FLT uptake seems to be associated with reduced overall survival and could be an important prognostic factor if this tendency can be confirmed in a larger prospective trial.

Key Words: 18F-FLT • HCC • proliferation • PET

* Contributed equally to this work.

COPYRIGHT © 2009 by the Society of Nuclear Medicine, Inc.


Related articles in JNM:

This Month in JNM

JNM 2009 50: 11A-12A. [Full Text]  





HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH RSS TABLE OF CONTENTS
JOURNAL OF NUCLEAR MEDICINE TECHNOLOGY THE JOURNAL OF NUCLEAR MEDICINE
Copyright © 2009 by the Society of Nuclear Medicine.