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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

Linear regression analysis of the individual SUVmax (A) and T/N ratio (B) of the tumor between11C-4DST and18F-FLT. A highly significant correlation is observed between the individual SUV max of 11C-4DST and 18F-FLT (r = 0.71, P < 0.001) and T/N ratio of 11C-4DST and 18F-FLT (r = 0.79, P < 0.0001). 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine; SUVmax, maximum standardized uptake value; T/N ratio, tumor-to-normal tissue uptake ratio.
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Fig4: Linear regression analysis of the individual SUVmax (A) and T/N ratio (B) of the tumor between11C-4DST and18F-FLT. A highly significant correlation is observed between the individual SUV max of 11C-4DST and 18F-FLT (r = 0.71, P < 0.001) and T/N ratio of 11C-4DST and 18F-FLT (r = 0.79, P < 0.0001). 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine; SUVmax, maximum standardized uptake value; T/N ratio, tumor-to-normal tissue uptake ratio.

Mentions: A highly significant correlation was observed between the individual SUVmax of 11C-4DST and 18F-FLT in the tumor (r = 0.71, P < 0.001) (Figure 4A). A highly significant correlation was also observed between the individual T/N ratio of 11C-4DST and 18F-FLT in the tumor (r = 0.79, P = 0.0001) (Figure 4B).Figure 4


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)

Linear regression analysis of the individual SUVmax (A) and T/N ratio (B) of the tumor between11C-4DST and18F-FLT. A highly significant correlation is observed between the individual SUV max of 11C-4DST and 18F-FLT (r = 0.71, P < 0.001) and T/N ratio of 11C-4DST and 18F-FLT (r = 0.79, P < 0.0001). 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine; SUVmax, maximum standardized uptake value; T/N ratio, tumor-to-normal tissue uptake ratio.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

Fig4: Linear regression analysis of the individual SUVmax (A) and T/N ratio (B) of the tumor between11C-4DST and18F-FLT. A highly significant correlation is observed between the individual SUV max of 11C-4DST and 18F-FLT (r = 0.71, P < 0.001) and T/N ratio of 11C-4DST and 18F-FLT (r = 0.79, P < 0.0001). 18F-FLT, 3′-deoxy-3′-[18F]fluorothymidine; 11C-4DST, 4′-[methyl-11C]thiothymidine; SUVmax, maximum standardized uptake value; T/N ratio, tumor-to-normal tissue uptake ratio.
Mentions: A highly significant correlation was observed between the individual SUVmax of 11C-4DST and 18F-FLT in the tumor (r = 0.71, P < 0.001) (Figure 4A). A highly significant correlation was also observed between the individual T/N ratio of 11C-4DST and 18F-FLT in the tumor (r = 0.79, P = 0.0001) (Figure 4B).Figure 4

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