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Comparison of 18F-FLT PET and 18F-FDG PET for preoperative staging in non-small cell lung cancer

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European Journal of Nuclear Medicine and Molecular Imaging Aims and scope Submit manuscript

Abstract

Purpose

The nucleoside analog 3′-deoxy-3′-18F-fluorothymidine (FLT) has been introduced for imaging cell proliferation with positron emission tomography (PET). We prospectively compared the diagnostic efficacy of FLT PET with that of 2-deoxy-2-18F-fluoro-d-glucose (FDG) PET for the preoperative nodal and distant metastatic staging of non-small cell lung cancer (NSCLC).

Methods

A total of 34 patients with NSCLC underwent FLT PET and FDG PET. PET imaging was performed at 60 min after each radiotracer injection. The PET images were evaluated qualitatively for regions of focally increased metabolism. For visualized primary tumors, the maximum standardized uptake value (SUV) was calculated. Nodal stages were determined by using the American Joint Committee on Cancer staging system and surgical and histologic findings reference standards.

Results

For the depiction of primary tumor, sensitivity of FLT PET was 67%, compared with 94% for FDG PET (P = 0.005). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy for lymph node staging on a per-patient basis were 57, 93, 67, 89, and 85%, respectively, with FLT PET and 57, 78, 36, 91, and 74%, respectively, with FDG PET (P > 0.1 for all comparisons). Two of the three distant metastases were detected with FLT and FDG PET.

Conclusion

In NSCLC, FLT PET showed better (although not statistically significant) specificity, positive predictive value and accuracy for N staging on a per-patient basis than FDG PET. However, FDG PET was found to have higher sensitivity for depiction of primary tumor than FLT PET.

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Authors and Affiliations

  1. Department of Radiology, Faculty of Medicine, Kagawa University, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa, 761-0793, Japan

    Yuka Yamamoto, Yoshihiro Nishiyama, Naruhide Kimura & Motoomi Ohkawa

  2. Department of Second Surgery, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Shinya Ishikawa & Masaya Okuda

  3. Department of First Internal Medicine, Faculty of Medicine, Kagawa University, Kagawa, Japan

    Shuji Bandoh & Nobuhiro Kanaji

  4. Department of Pharmacy, Kagawa University Hospital, Kagawa, Japan

    Masato Asakura

Authors
  1. Yuka Yamamoto
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  2. Yoshihiro Nishiyama
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  3. Naruhide Kimura
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  4. Shinya Ishikawa
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  5. Masaya Okuda
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  9. Motoomi Ohkawa
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Correspondence to Yuka Yamamoto.

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Yamamoto, Y., Nishiyama, Y., Kimura, N. et al. Comparison of 18F-FLT PET and 18F-FDG PET for preoperative staging in non-small cell lung cancer. Eur J Nucl Med Mol Imaging 35, 236–245 (2008). https://doi.org/10.1007/s00259-007-0613-0

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  • DOI: https://doi.org/10.1007/s00259-007-0613-0

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