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1-[11C]-acetate PET imaging in head and neck cancer—a comparison with 18F-FDG-PET: implications for staging and radiotherapy planning

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Abstract

Purpose

The aim of this study was to evaluate the feasibility of using 1-[11C]-acetate positron emission tomography (ACE-PET) to detect and delineate the gross tumour volume of head and neck cancer before radiotherapy, and to compare the results with those obtained using 18F-fluoro-2-deoxy-D-glucose (FDG) PET.

Methods

Ten patients with histologically verified squamous cell carcinoma were investigated by FDG-PET and dynamic ACE-PET prior to radiotherapy. The two scans were performed on the same day or on consecutive days, except in one patient in whom they were done 5 days apart. Diagnostic CT or MRI was performed in all patients. The image data sets were analysed both visually and semi-quantitatively. All primary tumours and metastases were delineated automatically by using the 50% threshold of maximum radioactivity corrected for background. The mean standardised uptake value (SUV) and the tumour volumes were evaluated and compared.

Results

All ten primary tumours were detected by ACE-PET, while nine primaries were detected by FDG-PET and CT and/or MRI. The ACE SUV tended to be lower than the FDG SUV (5.3±2.7 vs 9.6±7.0, p=0.07). The tumour volumes delineated with ACE were on average 51% larger than the FDG volumes (p<0.05). ACE-PET identified 20/21 lymph node metastases, while only 13/21 lesions were detected by FDG-PET and 16/21 lesions by CT or MRI.

Conclusion

ACE-PET appears promising for the staging of head and neck cancer. The biological information provided by both FDG and ACE must be carefully validated before it can be used in clinical routine for radiation treatment planning. More studies are needed to evaluate the differences in volumes and to confirm the clinical potential of both FDG and ACE-PET, especially in radiotherapy.

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Acknowledgements

The authors wish to thank the staff at Uppsala Imanet PET Center for assistance in performing the studies. This work was supported by grants from Uppsala University Amersham PET Research Fund, Laryngfonden and Umeå University Lion’s Cancer Research Foundation, Sweden. None of the authors have any financial conflict of interest.

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Authors and Affiliations

  1. Department of Radiation Sciences, Section of Oncology, Umeå University Hospital, 901 85, Umeå, Sweden

    Aijun Sun & Silvia Johansson

  2. Uppsala Imanet AB PET Center, Uppsala, Sweden

    Jens Sörensen & Bengt Langström

  3. Department of Radiation Sciences, Radiation Physics, Umeå University Hospital, Umeå, Sweden

    Mikael Karlsson

  4. Department of Oncology, Uppsala University Hospital, Uppsala, Sweden

    Ingela Turesson & Lena Cederblad

  5. Department of Radiation Physics, Lund University Hospital, Lund, Sweden

    Per Nilsson

  6. Hermes Medical Solution, Stockholm, Sweden

    Jan Bertling

  7. Department of Radiation Sciences, Diagnostic Radiology, Umeå University Hospital, Umeå, Sweden

    Katrine Riklund

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  1. Aijun Sun
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Correspondence to Aijun Sun.

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The first two authors contributed equally to this paper.

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Sun, A., Sörensen, J., Karlsson, M. et al. 1-[11C]-acetate PET imaging in head and neck cancer—a comparison with 18F-FDG-PET: implications for staging and radiotherapy planning. Eur J Nucl Med Mol Imaging 34, 651–657 (2007). https://doi.org/10.1007/s00259-006-0298-9

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  • DOI: https://doi.org/10.1007/s00259-006-0298-9

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