Abstract
The aim of this study was to evaluate the use of [18F]fluorothymidine (FLT) as a positron emission tomography (PET) tracer for the diagnosis of breast cancer. To this end, 12 patients with 14 primary breast cancer lesions (T2–T4) were studied by FLT-PET. For comparison, [18F]fluorodeoxyglucose (FDG) PET scans were performed in six patients. Thirteen of the 14 primary tumours demonstrated focally increased FLT uptake (SUVmean=3.4±1.1). Seven out of eight patients with histologically proven axillary lymph node metastases showed focally increased FLT uptake in the corresponding areas (SUVmean=2.4±1.2). The lowest SUV (mean =0.7) was observed in one of two inflammatory cancers. The contrast between primary tumours or metastases and surrounding tissue was high in most cases. In direct comparison to FDG-PET, the SUVs of primary tumours (5/6) and axillary lymph node metastases (3/4) were lower in FLT-PET (SUVFLT: 3.2 vs SUVFDG: 4.7 in primary tumours and SUVFLT: 2.9 vs SUVFDG: 4.6 in lymph node metastases). Since FLT uptake in surrounding breast tissue was also lower, tumour contrast was comparable to that with FDG. It is of note that normal FLT uptake was very low in the mediastinum, resulting in a higher tumour-to-mediastinum ratio as compared to FDG (P=0.03). FLT-PET is suitable for the diagnosis of primary breast cancer and locoregional metastases. High image contrast may facilitate the detection of small foci, especially in the mediastinum.
References
Bomanji JB, Costa DC, Ell PJ. Clinical role of positron emission tomography in oncology. Lancet Oncol 2001; 2:157–164.
Shields AF, Grierson JR, Dohmen BM, Machulla HJ, Stayanoff JC, LawhornCrews JM, Obradovich JE, Muzik O, Mangner TJ. Imaging proliferation in vivo with [F-18]FLT and positron emission tomography. Nature Medicine 1998; 4:1334–1336.
Rasey JS, Grierson JR, Wiens LW, Kolb PD, Schwartz JL. Validation of FLT uptake as a measure of thymidine kinase-1 activity in A549 carcinoma cells. J Nucl Med 2002; 43:1210–1217.
Buck AK, Schirrmeister H, Hetzel M, von der Heide M, Halter G, Glatting G, Mattfeldt T, Liewald F, Reske SN, Neumaier B. 3-deoxy-3-[(18)F] fluorothymidine-positron emission tomography for noninvasive assessment of proliferation in pulmonary nodules. Cancer Res 2002; 62:3331–3334.
Vesselle H, Grierson J, Muzi M, Pugsley JM, Schmidt RA, Rabinowitz P, Peterson LM, Vallieres E, Wood DE. In vivo validation of 3’deoxy-3’-[(18)F]fluorothymidine ([(18)F]FLT) as a proliferation imaging tracer in humans: correlation of [(18)F]FLT uptake by positron emission tomography with Ki-67 immunohistochemistry and flow cytometry in human lung tumors. Clin Cancer Res 2002; 8:3315–3323.
Dohmen BM, Kuntzsch M, Dittmann H, Wei R, Eschmann SM, Machulla H-J, Bares R. FLT-Metabolismus beim Menschen: Konsequenzen für die [F-18]FLT-PET. Nuklearmedizin 2001; 39:V19.
Dittmann H, Dohmen BM, Paulsen F, Eichhorn K, Eschmann SM, Horger M, Wehrmann M, Machulla HJ, Bares R. [(18)F]FLT PET for diagnosis and staging of thoracic tumours. Eur J Nucl Med Mol Imaging 2003; 30:1407–1412.
Lu I, Samuelsson L, Bergstrom M, Sato M, Fasth KJ, Langstrom B. Rat studies comparing 11C-FMAU, 18-FLT, and 76Br-BFU as proliferation marker. J Nucl Med 2002; 43:1688–1698.
Grierson JR, Vesselle H, Hofstrand P, Chin L, Rasey JS. Comparative uptake and cell cycle measurements with [F-18]FLT vs [H-3]thymidine in mammalian tumor cells. J Nucl Med 1998; 39:229P–230P.
Morabito A, Magnani E, Gion M, Sarmiento R, Capaccetti B, Longo R, Gattuso D, Gasparini G. Prognostic and predictive indicators in operable breast cancer. Clin Breast Cancer 2003; 3:381–390.
Joensuu H, Isola J, Lundin M, Salminen T, Holli K, Kataja V, Pylkkanen L, Turpeenniemi-Hujanen T, Von Smitten K, Lundin J. Amplification of erbB2 and erbB2 expression are superior to estrogen receptor status as risk factors for distant recurrence in pT1 N0M0 breast cancer: a nationwide population-based study. Clin Cancer Res 2003; 9:923–930.
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Smyczek-Gargya, B., Fersis, N., Dittmann, H. et al. PET with [18F]fluorothymidine for imaging of primary breast cancer: a pilot study. Eur J Nucl Med Mol Imaging 31, 720–724 (2004). https://doi.org/10.1007/s00259-004-1462-8
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DOI: https://doi.org/10.1007/s00259-004-1462-8