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Is ¹⁸F-3'-Fluoro-3'-Deoxy-L-Thymidine Useful for the Staging and Restaging of Non-Small Cell Lung Cancer?

¹ PET Center, Groningen University Hospital, Groningen, The Netherlands
² Department of Surgical Oncology, Groningen University Hospital, Groningen, The Netherlands
³ Department of Pathology and Laboratory Medicine, Groningen University Hospital, Groningen, The Netherlands
⁴ Department of Pulmonary Diseases, Groningen University Hospital, Groningen, The Netherlands

View larger version (95K): [in a new window]   FIGURE 1. Coronal 18F-FDG PET image (A), 18F-FLT PET image (B), and CT image (C) of patient 11, diagnosed with squamous cell carcinoma in the right upper bronchus (small white arrow) and distally with suspected postobstruction pneumonia (large white arrow) on CT. Avid uptake of 18F-FDG can be seen in a pretracheal lesion and in the primary tumor, which is in an area of elevated uptake, probably postobstructive pneumonia (black arrow). Less avid uptake of 18F-FLT can be seen in the area of the tumor, and little 18F-FLT uptake can be seen in the suspected infected area (black arrow).The bone marrow of ribs and the shoulder bones, liver, and intestine show physiologic 18F-FLT uptake.

View larger version (98K): [in a new window]   FIGURE 2. Coronal 18F-FDG PET image (A) and 18F-FLT PET image (B) of patient 9, with multiple lesions in both lungs on 18F-FDG PET and no lesions on 18F-FLT PET. Metastasis in the right acetabulum, which had been irradiated 1 wk earlier, is prominent on 18F-FDG PET (large arrow) but less intense on 18F-FLT PET (large arrow). In addition, irradiated bone marrow cranial of tumor has become metabolically inactive, as is seen on 18F-FLT as uptake less intense than that in nonirradiated bone marrow (small arrow).

View larger version (68K): [in a new window]   FIGURE 3. Coronal and transaxial 18F-FDG PET (A), 18F-FLT PET (B), and CT (C) images of patient 4, diagnosed with a large tumor in the right lower lung and a large metastasis in the liver (large arrows on PET images). The liver metastasis, with a 4.5-cm diameter, can be seen on CT. 18F-FDG PET showed avid uptake in the lung tumor and liver metastasis, whereas 18F-FLT uptake was slightly less in the pulmonary lesion and almost absent in the liver metastasis.