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Clinical significance of 18F-α-methyl tyrosine PET/CT for the detection of bone marrow invasion in patients with oral squamous cell carcinoma: comparison with 18F-FDG PET/CT and MRI

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Abstract

Objective

L-3-[18F]-fluoro-α-methyl tyrosine (18F-FAMT) is an amino acid tracer for positron emission tomography/computed tomography (PET/CT) which specifically transported into cancer cells by L-type amino acid transporter 1 (LAT1). LAT1 overexpression in tumors is significantly correlated with cell proliferation and angiogenesis. 18F-FAMT PET/CT, fluorine-18-fluorodeoxyglucose (18F-FDG) PET/CT and magnetic resonance imaging (MRI) were compared for their diagnostic performance in the detection of bone marrow invasion in patients with oral squamous cell carcinoma (OSCC).

Methods

Twenty-seven patients with OSCC on the upper or lower alveolar ridge underwent staging by MRI, 18F-FDG PET/CT and 18F-FAMT PET/CT studies before surgery. Post-surgical pathologic examination was used as the standard to determine the final diagnoses. The possibility of bone marrow invasion on MRI, 18F-FDG PET/CT and 18F-FAMT PET/CT were usually graded retrospectively into five-point score. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated according to the obtained scores.

Results

As the sensitivity of 18F-FDG PET/CT was highest (100 %) among that of MRI (95 %) and 18F-FAMT PET/CT (90 %), the specificity of 18F-FAMT PET/CT was highest (85.7 %) among that of MRI (57 %) and 18F-FDG PET/CT (14.3 %). The size of pathological tumor was accorded with that detected by 18F-FAMT PET/CT and was smaller than that detected by 18F-FDG PET/CT (P < 0.01). Significant difference was not found between 18F-FAMT PET tumor volume and pathological tumor volume.

Conclusions

18F-FAMT PET/CT was useful and more specific than MRI or 18F-FDG PET/CT in the detection of bone marrow invasion of OSCC and may contribute to minimize the extent of resection in oral surgery patient.

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Authors and Affiliations

  1. Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Mai Kim, Go Miyashita, Hidetaka Miyazaki, Akihide Negishi & Satoshi Yokoo

  2. Department of Diagnostic Radiology and Nuclear Medicine, Gunma University Graduate School of Medicine, Showa-machi 3-39-22, Maebashi, Gunma, 371-8511, Japan

    Tetsuya Higuchi, Yukiko Arisaka, Arifudin Achmad, Azusa Tokue & Yoshito Tsushima

  3. Department of Molecular Imaging, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma, 371-8511, Japan

    Hideyuki Tominaga

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  1. Mai Kim
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Correspondence to Mai Kim.

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Kim, M., Higuchi, T., Arisaka, Y. et al. Clinical significance of 18F-α-methyl tyrosine PET/CT for the detection of bone marrow invasion in patients with oral squamous cell carcinoma: comparison with 18F-FDG PET/CT and MRI. Ann Nucl Med 27, 423–430 (2013). https://doi.org/10.1007/s12149-013-0701-0

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  • DOI: https://doi.org/10.1007/s12149-013-0701-0

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