RT Journal Article
SR Electronic
T1 Comparison of <sup>11</sup>C-Choline and <sup>18</sup>F-FDG PET in Primary Diagnosis and Staging of Patients with Thoracic Cancer
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 167
OP 172
VO 43
IS 2
A1 Pieterman, Remge M.
A1 Que, Tjin H.
A1 Elsinga, Philip H.
A1 Pruim, Jan
A1 van Putten, John W.G.
A1 Willemsen, Antoon T.M.
A1 Vaalburg, Willem
A1 Groen, Harry J.M.
YR 2002
UL http://jnm.snmjournals.org/content/43/2/167.abstract
AB PET with 18F-FDG is used for detection and staging of thoracic cancer; however, more specific PET radiopharmaceuticals would be welcome. 11C-labeled choline (CHOL) is a new radiopharmaceutical potentially useful for tumor imaging, since it is incorporated into cell membranes as phosphatidylcholine. The aim of this study was to investigate whether 11C-CHOL PET has advantages over 18F-FDG PET in patients with thoracic cancer. Methods: We evaluated 17 patients with thoracic cancer both with 11C-CHOL PET and 18F-FDG PET. After transmission scanning, 11C-CHOL was injected intravenously, and whole-body scanning was started after 5 min. Immediately thereafter, 18F-FDG was injected intravenously, followed after 90 min by interleaved attenuation-corrected whole-body scanning. Scans were performed from crown to femur. Visual and quantitative (standardized uptake value) analyses of 11C-CHOL PET and 18F-FDG PET were performed and compared with results of traditional staging and follow-up. Results: The most prominent features of normal 11C-CHOL distribution were high uptake in liver, renal cortex, and salivary glands. Except for some uptake in choroid plexus and pituitary gland, brain uptake was negligible. All primary thoracic tumors were detected with 11C-CHOL PET and 18F-FDG PET. Both 11C-CHOL PET and 18F-FDG PET correctly identified all 16 patients with lymph node involvement. However, in a lesion-to-lesion analysis, 11C-CHOL PET detected only 29 of 43 metastatic lymph nodes, whereas 18F-FDG PET detected 41 of 43. 11C-CHOL PET detected fewer intrapulmonary and pleural metastases than 18F-FDG PET (27/47 vs. 46/47). More brain metastases were detected with 11C-CHOL PET (23/23) than with 18F-FDG PET (3/23). For primary tumors, the median (range) standard uptake values of 11C-CHOL and 18F-FDG were 1.68 (0.98–3.22) and 4.22 (1.40–8.26), respectively (P = 0.001). Conclusion: 11C-CHOL PET can be used to visualize thoracic cancers. Although detection of lymph node metastases with 11C-CHOL PET was inferior compared with 18F-FDG PET, the detection of brain metastases was superior.