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European Journal of Nuclear Medicine and Molecular Imaging

Erschienen in:

01.04.2005 | Original Article

Clinical relevance of imaging proliferative activity in lung nodules

verfasst von: Andreas K. Buck, Martin Hetzel, Holger Schirrmeister, Gisela Halter, Peter Möller, Clemens Kratochwil, Andreas Wahl, Gerhard Glatting, Felix M. Mottaghy, Torsten Mattfeldt, Bernd Neumaier, Sven N. Reske

Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging | Ausgabe 5/2005

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Abstract

Purpose

Recently, the thymidine analogue 3′-deoxy-3′[¹⁸F]fluorothymidine (FLT) has been introduced for imaging proliferation with positron emission tomography (PET). In this prospective study, we examined the accuracy of FLT for differentiation of benign from malignant lung lesions and for tumour staging.

Methods

A total of 47 patients with newly diagnosed pulmonary nodules on chest CT suspicious for malignancy were examined with FLT-PET in addition to routine staging procedures. A total of 43 patients also underwent 2-[¹⁸F]fluoro-2-deoxy-D-glucose (FDG) PET imaging. Within 2 weeks, patients underwent resective surgery or core biopsy of the pulmonary lesion.

Results

Histopathology revealed malignant lung tumours in 32 patients (20 non-small cell lung cancer, 1 small cell lung cancer, 1 pulmonary carcinoid, 1 non-Hodgkin’s lymphoma, nine metastases from extrapulmonary tumours) and benign lesions in 15 patients. Increased FLT uptake was exclusively related to malignant tumours. FLT-PET was false negative in two patients with non-small cell lung cancer, in the patient with a pulmonary carcinoid and in three patients with lung metastases. The sensitivity of FLT-PET for detection of lung cancer was 90%, the specificity 100% and the accuracy 94%. Fifteen out of 21 patients with lung cancer had mediastinal lymph node metastases. FLT-PET was true positive in 7/15 patients, resulting in a sensitivity of 53% for N-staging (specificity 100%, accuracy 67%). Clinical TNM stage was correctly identified in 67% (20/30) patients, compared to 85% (23/27) with FDG-PET.

Conclusion

FLT-PET has a high specificity for the detection of malignant lung tumours. Compared with FDG, FLT-PET is less accurate for N-staging in patients with lung cancer and for detection of lung metastases. FLT-PET therefore cannot be recommended for staging of lung cancer.

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Titel: Clinical relevance of imaging proliferative activity in lung nodules
verfasst von: Andreas K. Buck
Martin Hetzel
Holger Schirrmeister
Gisela Halter
Peter Möller
Clemens Kratochwil
Andreas Wahl
Gerhard Glatting
Felix M. Mottaghy
Torsten Mattfeldt
Bernd Neumaier
Sven N. Reske
Publikationsdatum: 01.04.2005
Verlag: Springer-Verlag
Erschienen in: European Journal of Nuclear Medicine and Molecular Imaging / Ausgabe 5/2005
Print ISSN: 1619-7070
Elektronische ISSN: 1619-7089
DOI: https://doi.org/10.1007/s00259-004-1706-7

Springer Medizin

Abstract

Purpose

Methods

Results

Conclusion

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