A Multicenter Clinical Trial on the Diagnostic Value of Dual-Tracer PET/CT in Pulmonary Lesions Using 3'-Deoxy-3'-18F-Fluorothymidine and 18F-FDG
Jiahe Tian 1*,
Xiaofeng Yang 2,
Lijuan Yu 3,
Ping Chen 4,
Jun Xin 5,
Liming Ma 6,
Huiru Feng 7,
Yieyin Tan 1,
Zhoushe Zhao 8,
and
Wenkai Wu 9
1 Department of Nuclear Medicine, The Chinese PLA General Hospital, Beijing, China
2 Department of Nuclear Medicine, The People's Hospital of Xinjiang Uygur Autonomous Region, Urumuqi, China
3 Department of Medical Imaging, The Tumor Hospital Affiliated to Harbin Medical University, Heilongjiang, China
4 PET/CT Center, The 1st Affiliated Hospital of Guangzhou Medical University, Guanzhou, China
5 Department of Radiology, The 2nd Affiliated Hospital of China Medical University, Shenyang, China
6 Department of Nuclear Medicine, The Kunming General Hospital, Yunan, China
7 Department of Nuclear Medicine, The General Hospital of Beijing Command, Beijing, China
8 Health Care System, GE China, Beijing, China
9 Department of Nuclear Medicine, Cancer Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
* To whom correspondence should be addressed. E-mail: tianjh{at}vip.sina.com.cn.
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Abstract |
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Some new radiotracers might add useful information and improve diagnostic confidence of 18F-FDG imaging in tumors. A multicenter clinical trial was designed to investigate the diagnostic performance of dual-tracer (18F-FDG and 3'-deoxy-3'-18F-fluorothymidine [18F-FLT]) PET/CT in pulmonary nodules. Methods: Fifty-five patients underwent dual-tracer imaging in 6 imaging centers using the same models of equipment and standardized protocols. The images were interpreted by a collective group of readers who were unaware of the clinical data. The diagnostic performance using either tracer alone or dual-tracers together, with or without CT, was compared. The histological diagnosis or clinical findings in a 12-mo follow-up period served as the standard of truth. Results: In 16 patients of malignant tumor, 16 tuberculoses, and 23 other benign lesions, the sensitivity and specificity of 18F-FDG and 18F-FLT were 87.5% and 58.97% and 68.75% and 76.92%, respectively. The combination of dual-tracer PET/CT improved the sensitivity and specificity up to 100% and 89.74%. The 3 subgroups of patients could be best separated when the 18F-FLT/18F-FDG standardized uptake value ratio of 0.4–0.90 was used as the threshold. Conclusion: By reflecting different biologic features, the dual-tracer PET/CT using 18F-FDG and 18F-FLT favorably affected the diagnosis of lung nodules.
Key Words:
pulmonary nodules, 18F-FDG, 3'-deoxy-3'-18F-fluorothymidine, dual-tracer PET/CT, multicenter clinical trial
