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Relationship Between Retention Index in Dual-Phase 18F-FDG PET, and Hexokinase-II and Glucose Transporter-1 Expression in Pancreatic Cancer

Tatsuya Higashi, MD, PhD1, Tsuneo Saga, MD, PhD1, Yuji Nakamoto, MD, PhD1, Takayoshi Ishimori, MD1, Marcelo H. Mamede, MD1, Michihiko Wada, MD, PhD2, Ryuichiro Doi, MD, PhD2, Ryo Hosotani, MD, PhD2, Masayuki Imamura, MD, PhD2 and Junji Konishi, MD, PhD1

1 Department of Nuclear Medicine and Diagnostic Imaging, Graduate School of Medicine, Kyoto University, Kyoto, Japan
2 Department of Surgery and Surgical Basic Science, Graduate School of Medicine, Kyoto University, Kyoto, Japan



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  		FIGURE 1. Results of SUV at 1 h and RI of dual-phase 18F-FDG PET. Positive correlation existed between SUV at 1 h and RI (P < 0.05). Four patients with negative RI showed low SUVs at 1 h.

 


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  		FIGURE 2. Results of immunohistochemical staining using anti-GLUT-1 and anti-HK-II. They correlated closely (P < 0.005).

 


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  		FIGURE 3. Results of comparative analysis between quantitative values of dual-phase 18F-FDG PET and immunohistochemical staining. SUV at 1 h showed a weak positive correlation with GLUT-1 glucose transporter expression (P = 0.055), whereas no significant relationship was found between SUV at 1 h and HK-II hexokinase expression. However, RI had no significant relationship with GLUT-1 glucose transporter expression, whereas RI and HK-II hexokinase expression had significant positive relationship (P < 0.05).

 


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  		FIGURE 4. Invasive ductal adenocarcinoma (arrows) in pancreatic head of patient 1. 18F-FDG PET images obtained at 1 h, when tumor SUV was 2.82 (A), and at 2 h, when tumor SUV was 2.48 (B), with RI of -12.1%. Immunohistochemical staining of GLUT-1 (C) and of HK-II (D) shows no significant strong expression of GLUT-1 or HK-II. Percentages of strong expressed cells of both proteins were scored as <20%. (x400; bar = 20 µm)

 


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  		FIGURE 5. Invasive ductal adenocarcinoma (arrows) in pancreatic head of patient 17. 18F-FDG PET images obtained at 1 h, when tumor SUV was 6.0 (A), and at 2 h, when tumor SUV was 7.75 (B), with RI of 29.2%. Immunohistochemical staining of GLUT-1 (C) and of HK-II (D) shows overexpression of GLUT-1 and HK-II. Expression of GLUT-1 is observed mainly in membrane, whereas that of HK-II is observed mainly in cytoplasm. Percentages of strong expressed cells of GLUT-1 were scored as 50%–80%, and those of HK-II were scored as >80%. (x400; bar = 20 µm)

 




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