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Comparison of 4'-[methyl-(11)C]thiothymidine ((11)C-4DST) and 3'-deoxy-3'-[(18)F]fluorothymidine ((18)F-FLT) PET/CT in human brain glioma imaging.

Toyota Y, Miyake K, Kawai N, Hatakeyama T, Yamamoto Y, Toyohara J, Nishiyama Y, Tamiya T - EJNMMI Res (2015)

Bottom Line: These values were compared among different glioma grades.Significant correlations were also found between the Ki-67 labeling index and the T/B ratio of (11)C-4DST (r = 0.52, P < 0.05) and (18)F-FLT (r = 0.55, P < 0.05).Moreover, no superiority was found in (11)C-4DST over (18)F-FLT in the evaluation of cell proliferation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Kagawa, 761-0793 Japan.

ABSTRACT

Background: 3'-deoxy-3'-[(18)F]fluorothymidine ((18)F-FLT) has been used to evaluate tumor malignancy and cell proliferation in human brain gliomas. However, (18)F-FLT has several limitations in clinical use. Recently, (11)C-labeled thymidine analogue, 4'-[methyl-(11)C]thiothymidine ((11)C-4DST), became available as an in vivo cell proliferation positron emission tomography (PET) tracer. The present study was conducted to evaluate the usefulness of (11)C-4DST PET in the diagnosis of human brain gliomas by comparing with the images of (18)F-FLT PET.

Methods: Twenty patients with primary and recurrent brain gliomas underwent (18)F-FLT and (11)C-4DST PET scans. The uptake values in the tumors were evaluated using the maximum standardized uptake value (SUVmax), the tumor-to-normal tissue uptake (T/N) ratio, and the tumor-to-blood uptake (T/B) ratio. These values were compared among different glioma grades. Correlation between the Ki-67 labeling index and the uptake values of (11)C-4DST and (18)F-FLT in the tumor was evaluated using linear regression analysis. The relationship between the individual (18)F-FLT and (11)C-4DST uptake values in the tumors was also examined.

Results: (11)C-4DST uptake was significantly higher than that of (18)F-FLT in the normal brain. The uptake values of (11)C-4DST in the tumor were similar to those of (18)F-FLT resulting in better visualization with (18)F-FLT. No significant differences in the uptake values of (18)F-FLT and (11)C-4DST were noted among different glioma grades. Linear regression analysis showed a significant correlation between the Ki-67 labeling index and the T/N ratio of (11)C-4DST (r = 0.50, P < 0.05) and (18)F-FLT (r = 0.50, P < 0.05). Significant correlations were also found between the Ki-67 labeling index and the T/B ratio of (11)C-4DST (r = 0.52, P < 0.05) and (18)F-FLT (r = 0.55, P < 0.05). A highly significant correlation was observed between the individual T/N ratio of (11)C-4DST and (18)F-FLT in the tumor (r = 0.79, P = 0.0001).

Conclusions: The present study demonstrates that (11)C-4DST is useful for the imaging of human brain gliomas with PET. A relatively higher background uptake of (11)C-4DST in the normal brain compared to (18)F-FLT limits the detection of low-tracer-uptake tumors. Moreover, no superiority was found in (11)C-4DST over (18)F-FLT in the evaluation of cell proliferation.

No MeSH data available.


Related in: MedlinePlus

Gd-enhanced T1-weighted MRI,11C-4DST PET, and18F-FLT PET of two patients. (A) A 76-year-old woman with newly diagnosed glioblastoma (Case 8). Gd-enhanced T1-weighted MR image demonstrates a round lesion with irregular ring enhancement in the right frontal lobe. PET studies with 11C-4DST and 18F-FLT PET show almost identical tracer uptake in the tumor. Background uptake of 11C-4DST is higher than 18F-FLT PET. (B) A 29-year-old woman with recurrent glioblastoma with oligodendroglioma component (Case 20). Gd-enhanced T1-weighted MR image demonstrates multiple spotty enhancements in the right temporo-occipital lobes extending to the basal ganglia. The tumor is faintly visualized with 11C-4DST but well visualized with 18F-FLT. 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine.
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Fig2: Gd-enhanced T1-weighted MRI,11C-4DST PET, and18F-FLT PET of two patients. (A) A 76-year-old woman with newly diagnosed glioblastoma (Case 8). Gd-enhanced T1-weighted MR image demonstrates a round lesion with irregular ring enhancement in the right frontal lobe. PET studies with 11C-4DST and 18F-FLT PET show almost identical tracer uptake in the tumor. Background uptake of 11C-4DST is higher than 18F-FLT PET. (B) A 29-year-old woman with recurrent glioblastoma with oligodendroglioma component (Case 20). Gd-enhanced T1-weighted MR image demonstrates multiple spotty enhancements in the right temporo-occipital lobes extending to the basal ganglia. The tumor is faintly visualized with 11C-4DST but well visualized with 18F-FLT. 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine.

Mentions: Both 11C-4DST and 18F-FLT showed little uptake in the normal brain, and 11C-4DST uptake was visually higher than 18F-FLT in almost all cases. 11C-4DST showed a high uptake in the choroid plexus, whereas 18F-FLT showed a faint uptake. 11C-4DST and 18F-FLT provided identical PET images of the tumor in many cases (Figure 2A). Two primary diffuse astrocytomas that had no contrast enhancement in the tumor could not be visualized with 11C-4DST. One of the two diffuse astrocytomas could be visualized with 18F-FLT but the other could not. One recurrent glioblastoma with oligodendroglioma component that had multiple spotty enhancements in contrast-enhanced MRI was faintly visualized with 11C-4DST but well visualized with 18F-FLT (Figure 2B). In total, 2 of 20 tumors were well visualized only in 18F-FLT PET.Figure 2


Comparison of 4'-[methyl-(11)C]thiothymidine ((11)C-4DST) and 3'-deoxy-3'-[(18)F]fluorothymidine ((18)F-FLT) PET/CT in human brain glioma imaging.

Toyota Y, Miyake K, Kawai N, Hatakeyama T, Yamamoto Y, Toyohara J, Nishiyama Y, Tamiya T - EJNMMI Res (2015)

Gd-enhanced T1-weighted MRI,11C-4DST PET, and18F-FLT PET of two patients. (A) A 76-year-old woman with newly diagnosed glioblastoma (Case 8). Gd-enhanced T1-weighted MR image demonstrates a round lesion with irregular ring enhancement in the right frontal lobe. PET studies with 11C-4DST and 18F-FLT PET show almost identical tracer uptake in the tumor. Background uptake of 11C-4DST is higher than 18F-FLT PET. (B) A 29-year-old woman with recurrent glioblastoma with oligodendroglioma component (Case 20). Gd-enhanced T1-weighted MR image demonstrates multiple spotty enhancements in the right temporo-occipital lobes extending to the basal ganglia. The tumor is faintly visualized with 11C-4DST but well visualized with 18F-FLT. 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4385144&req=5

Fig2: Gd-enhanced T1-weighted MRI,11C-4DST PET, and18F-FLT PET of two patients. (A) A 76-year-old woman with newly diagnosed glioblastoma (Case 8). Gd-enhanced T1-weighted MR image demonstrates a round lesion with irregular ring enhancement in the right frontal lobe. PET studies with 11C-4DST and 18F-FLT PET show almost identical tracer uptake in the tumor. Background uptake of 11C-4DST is higher than 18F-FLT PET. (B) A 29-year-old woman with recurrent glioblastoma with oligodendroglioma component (Case 20). Gd-enhanced T1-weighted MR image demonstrates multiple spotty enhancements in the right temporo-occipital lobes extending to the basal ganglia. The tumor is faintly visualized with 11C-4DST but well visualized with 18F-FLT. 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine.
Mentions: Both 11C-4DST and 18F-FLT showed little uptake in the normal brain, and 11C-4DST uptake was visually higher than 18F-FLT in almost all cases. 11C-4DST showed a high uptake in the choroid plexus, whereas 18F-FLT showed a faint uptake. 11C-4DST and 18F-FLT provided identical PET images of the tumor in many cases (Figure 2A). Two primary diffuse astrocytomas that had no contrast enhancement in the tumor could not be visualized with 11C-4DST. One of the two diffuse astrocytomas could be visualized with 18F-FLT but the other could not. One recurrent glioblastoma with oligodendroglioma component that had multiple spotty enhancements in contrast-enhanced MRI was faintly visualized with 11C-4DST but well visualized with 18F-FLT (Figure 2B). In total, 2 of 20 tumors were well visualized only in 18F-FLT PET.Figure 2

Bottom Line: These values were compared among different glioma grades.Significant correlations were also found between the Ki-67 labeling index and the T/B ratio of (11)C-4DST (r = 0.52, P < 0.05) and (18)F-FLT (r = 0.55, P < 0.05).Moreover, no superiority was found in (11)C-4DST over (18)F-FLT in the evaluation of cell proliferation.

View Article: PubMed Central - PubMed

Affiliation: Department of Neurological Surgery, Faculty of Medicine, Kagawa University, Kagawa, 761-0793 Japan.

ABSTRACT

Background: 3'-deoxy-3'-[(18)F]fluorothymidine ((18)F-FLT) has been used to evaluate tumor malignancy and cell proliferation in human brain gliomas. However, (18)F-FLT has several limitations in clinical use. Recently, (11)C-labeled thymidine analogue, 4'-[methyl-(11)C]thiothymidine ((11)C-4DST), became available as an in vivo cell proliferation positron emission tomography (PET) tracer. The present study was conducted to evaluate the usefulness of (11)C-4DST PET in the diagnosis of human brain gliomas by comparing with the images of (18)F-FLT PET.

Methods: Twenty patients with primary and recurrent brain gliomas underwent (18)F-FLT and (11)C-4DST PET scans. The uptake values in the tumors were evaluated using the maximum standardized uptake value (SUVmax), the tumor-to-normal tissue uptake (T/N) ratio, and the tumor-to-blood uptake (T/B) ratio. These values were compared among different glioma grades. Correlation between the Ki-67 labeling index and the uptake values of (11)C-4DST and (18)F-FLT in the tumor was evaluated using linear regression analysis. The relationship between the individual (18)F-FLT and (11)C-4DST uptake values in the tumors was also examined.

Results: (11)C-4DST uptake was significantly higher than that of (18)F-FLT in the normal brain. The uptake values of (11)C-4DST in the tumor were similar to those of (18)F-FLT resulting in better visualization with (18)F-FLT. No significant differences in the uptake values of (18)F-FLT and (11)C-4DST were noted among different glioma grades. Linear regression analysis showed a significant correlation between the Ki-67 labeling index and the T/N ratio of (11)C-4DST (r = 0.50, P < 0.05) and (18)F-FLT (r = 0.50, P < 0.05). Significant correlations were also found between the Ki-67 labeling index and the T/B ratio of (11)C-4DST (r = 0.52, P < 0.05) and (18)F-FLT (r = 0.55, P < 0.05). A highly significant correlation was observed between the individual T/N ratio of (11)C-4DST and (18)F-FLT in the tumor (r = 0.79, P = 0.0001).

Conclusions: The present study demonstrates that (11)C-4DST is useful for the imaging of human brain gliomas with PET. A relatively higher background uptake of (11)C-4DST in the normal brain compared to (18)F-FLT limits the detection of low-tracer-uptake tumors. Moreover, no superiority was found in (11)C-4DST over (18)F-FLT in the evaluation of cell proliferation.

No MeSH data available.


Related in: MedlinePlus