Imaging of Proliferation in Hepatocellular Carcinoma with the In Vivo Marker 18F-Fluorothymidine

• DOI: 10.2967/jnumed.109.065896
• Publication Date: 2009-08-19T03:34:15Z
• Authors: Florian Eckel; Ken Herrmann; Stefan Schmidt; Claudia Hillerer; Hinrich A. Wieder; Bernd-Joachim Krause; Tibor Schuster; Rupert Langer; Hans-Jürgen Wester; Roland M. Schmid; Markus Schwaiger; Andreas K. Buck
• Keywords: Histology

We determined the ability of PET with thymidine analog 3'-deoxy-3'-(18)F-fluorothymidine ((18)F-FLT) to detect hepatocellular carcinoma (HCC).In this pilot study, (18)F-FLT was performed in 18 untreated patients clinically suspected HCC. Routine diagnostic procedures included ultrasound, MRI, or contrast-enhanced spiral CT upper gastrointestinal tract all patients. At 45-60 min after intravenous injection approximately 270-340 MBq (18)F-FLT, emission and transmission scanning a high-resolution scanner. Tracer uptake tumor surrounding liver tissue evaluated semiquantitatively by calculation mean maximum standardized values (SUVs). Results were correlated those conventional imaging methods.A total 13 tumors (sensitivity, 72%; 95% confidence interval [CI], 47%-90%) showed focal higher than activity detectable as hot lesions. Five characterized photopenic lesions contained mixture cold exhibiting comparable lower tissue. When considered, SUV 7.8 (range, 2.5-11.1), 9.3 2.9-14.3). Histology clinical follow-up revealed HCC 16 cholangiocarcinoma 2 In subgroup HCC, sensitivity for detection 69% (11/16; CI, 41%-89%). Correlation analysis demonstrated significant positive relationship between proliferation marker MIB-1 (r = 0.66, P 0.02). Survival (Cox proportional hazards regression) initial (mean SUVs) increased hazard ratios SUV, 1.20; 1.12), but because small number events, these results not statistically significant.In mixed pattern vivo (18)F-FLT. A that tissue, whereas remaining High seems be associated reduced overall survival could an important prognostic factor if tendency can confirmed larger prospective trial.