RT Journal Article
SR Electronic
T1 Is <sup>18</sup>F-3′-Fluoro-3′-Deoxy-<span class="sc">l</span>-Thymidine Useful for the Staging and Restaging of Non-Small Cell Lung Cancer?
JF Journal of Nuclear Medicine
JO J Nucl Med
FD Society of Nuclear Medicine
SP 1677
OP 1682
VO 45
IS 10
A1 David C.P. Cobben
A1 Philip H. Elsinga
A1 Harald J. Hoekstra
A1 Albert J.H. Suurmeijer
A1 Willem Vaalburg
A1 Bram Maas
A1 Pieter L. Jager
A1 Harry M.J. Groen
YR 2004
UL http://jnm.snmjournals.org/content/45/10/1677.abstract
AB The objective of this study was to compare 18F-3′-fluoro-3′-deoxy-l-thymidine (FLT) PET with clinical TNM staging, including that by 18F-FDG PET, in patients with non-small cell lung cancer (NSCLC). Methods: Patients with NSCLC underwent whole-body 18F-FDG PET and whole-body 18F-FLT PET, using a median of 360 MBq of 18F-FDG (range, 160–500 MBq) and a median of 210 MBq of 18F-FLT (range, 130–420 MBq). 18F-FDG PET was performed 90 min after 18F-FDG injection, and 18F-FLT PET was performed 60 min after 18F-FLT injection. Two viewers independently categorized the localization and intensity of tracer uptake for all lesions. All 18F-FDG PET and 18F-FLT PET lesions were compared. Staging with 18F-FLT PET was compared with clinical TNM staging based on the findings of history, physical examination, bronchoscopy, CT, and 18F-FDG PET. From 8 patients, standardized uptake values (SUVs) were calculated. Maximal SUV and mean SUV were calculated. Results: Sixteen patients with stage IB–IV NSCLC and 1 patient with strong suspicion of NSCLC were investigated. Sensitivity on a lesion-by-lesion basis was 80% for the 8 patients who received treatment before 18F-FLT PET and 27% for the 9 patients who did not receive pretreatment, using 18F-FDG PET as the reference standard. Compared with clinical TNM staging, staging by 18F-FLT PET was correct for 8 of 17 patients: 5 of 9 patients in the group with previous therapy and 3 of 8 patients in the group without previous therapy. The maximal SUV of 18F-FLT PET, at a median of 2.7 and range of 0.8–4.5, was significantly lower than that of 18F-FDG PET, which had a median of 8.0 and range of 3.7–18.8 (n = 8; P = 0.012). The mean SUV of 18F-FLT PET, at a median of 2.7 and range of 1.4–3.3, was significantly lower than that of 18F-FDG PET, which had a median of 6.2 and range of 2.8–13.9 (n = 6; P = 0.027). Conclusion: 18F-FLT PET is not useful for staging and restaging NSCLC.