Tumor Blood Flow Measured by PET Dynamic Imaging of First-Pass 18F-FDG Uptake: A Comparison with 15O-Labeled Water-Measured Blood Flow

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FIGURE 1.
Representative PET images of a head and neck tumor comparing ¹⁵O-water scans with ¹⁸F-FDG scans. (A) ¹⁵O-water uptake during the first 2 min. (B) First-pass ¹⁸F-FDG uptake during the first 2 min. (C) Late ¹⁸F-FDG uptake, 35–50 min. Transaxial and coronal views are shown.
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FIGURE 2.
Correlation between ¹⁵O-water uptake (0–2 min) and first-pass ¹⁸F-FDG uptake (0–2 min) in various tumors of all patients. Data were fit to the equation: ¹⁸F-FDG flow = 0.012 + (0.86 · ¹⁵O-water flow) (n = 190 ROI pairs). Data include both treated and untreated patients.
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FIGURE 3.
Case study using first-pass blood flow and late metabolic imaging of ¹⁸F-FDG PET scan of prostate cancer with ¹⁸F-FDG PET/CT. (A) Early (2 min) first-pass ¹⁸F-FDG scan for measurement of blood flow showing early uptake of ¹⁸F-FDG in prostate gland (Prostate Ca). (B) Late imaging of ¹⁸F-FDG metabolism (scan at 40 min) after injection of ¹⁸F-FDG.

TABLE 1

Comparison of Flow Estimates for Untreated and Treated Groups

Parameter	Untreated	Treated	P
Current study
n	65	126
¹⁵O-water flow (mL/min/g [mean ± SD])	0.21 ± 0.16	0.22 ± 0.15	0.43
¹⁸F-FDG flow (mL/min/g [mean ± SD])	0.18 ± 0.15	0.20 ± 0.14	0.09
SUV (mean ± SD)	5.40 ± 6.93	9.35 ± 11.7	0.002^*
¹⁸F-FDG flow ratio: ¹⁸F-FDG/¹⁵O-water flow	0.65	0.85
Literature values
K1 (¹⁸F-FDG)/¹⁵O-water flow ratio (26)	0.5	0.43
K1 (¹⁸F-FDG)/¹⁵O-water flow ratio (27)	0.56	—