11C-acetate PET imaging of lung cancer: Comparison with 18F-FDG PET and 99mTc-MIBI SPET

Kotaro Higashi, Yoshimichi Ueda, Ichiro Matsunari, Yuko Kodama, Ryosuke Ikeda, Katsuyuki Miura, Suzuka Taki, Takahiro Higuchi, Hisao Tonami, Itaru Yamamoto

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

Recently carbon-11 acetate (AC) positron emission tomography (PET) has been reported to be of clinical value for the diagnosis of cancer that is negative on fluorine-18 fluorodeoxyglucoce (FDG) PET. We investigated the uptake of AC in lung cancer to determine whether this tracer is of potential value for tumour detection and characterisation, and to compare AC PET imaging with FDG PET and technetium-99m sestamibi (MIBI) single-photon emission tomography (SPET). Twenty-three patients with 25 lung cancers underwent AC and FDG PET. Twenty of 23 patients were also investigated with MIBI SPET. Dynamic images were acquired for 26 min after the injection of 555 MBq of AC. Standardised uptake values (SUVs) and/or tumour to non-tumour activity ratios (T/N) for each tumour were investigated at 10-20 min after AC administration, 40-60 min after administration of 185 MBq FDG and 15-45 min after administration of 555 MBq MIBI. Twenty lung cancers were resected surgically, and the degree of tracer uptake in the primary lesion was correlated with histopathological features (cell dedifferentiation and aggressiveness) and prognosis. Rapid uptake of AC followed by extremely slow clearance was observed. For the purpose of tumour identification, AC PET was inferior to FDG PET in 8 of 25 (32%) lung cancers, and the T/N of AC was lower than that of FDG. However, AC PET was superior to FDG PET in the identification of a slow-growing tumour (bronchiolo-alveolar carcinoma). There was a positive correlation between AC uptake (T/N) and MIBI uptake (T/N) (r=0.799, P<0.0001). A positive correlation was not observed between either AC or MIBI uptake and the degree of cell dedifferentiation in lung adenocarcinomas, whereas FDG uptake did correlate with the degree of cell dedifferentiation. In lung adenocarcinoma, there was a weak correlation between aggressiveness and FDG uptake, but no correlation was evident for AC and MIBI. In addition, a positive correlation was not observed between AC or MIBI uptake and postoperative recurrence in lung adenocarcinoma, whereas FDG uptake did correlate with postoperative recurrence. Thus, the greater the FDG uptake, the higher the malignant grade. In conclusion, for the purpose of tumour identification, AC PET was inferior to FDG PET but superior to MIBI SPET. Neither AC nor MIBI uptake reflects the malignant grade in lung adenocarcinoma, whereas FDG uptake does. AC PET is less diagnostically informative than FDG PET in patients with lung cancer. However, AC PET may play a complementary role in the identification of low-grade malignancies that are not FDG avid.

Original languageEnglish
Pages (from-to)13-21
Number of pages9
JournalEuropean Journal of Nuclear Medicine and Molecular Imaging
Volume31
Issue number1
DOIs
Publication statusPublished - Jan 1 2004
Externally publishedYes

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Photons
Positron-Emission Tomography
Lung Neoplasms
Acetates
Tomography
Cell Dedifferentiation
Neoplasms
carbon-11 acetate
Bronchiolo-Alveolar Adenocarcinoma
Technetium Tc 99m Sestamibi
Recurrence
Fluorine

Keywords

  • C-acetate PET
  • F-FDG PET
  • Tc-sestamibi SPET
  • Lung cancer

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

11C-acetate PET imaging of lung cancer : Comparison with 18F-FDG PET and 99mTc-MIBI SPET. / Higashi, Kotaro; Ueda, Yoshimichi; Matsunari, Ichiro; Kodama, Yuko; Ikeda, Ryosuke; Miura, Katsuyuki; Taki, Suzuka; Higuchi, Takahiro; Tonami, Hisao; Yamamoto, Itaru.

In: European Journal of Nuclear Medicine and Molecular Imaging, Vol. 31, No. 1, 01.01.2004, p. 13-21.

Research output: Contribution to journalArticle

Higashi, K, Ueda, Y, Matsunari, I, Kodama, Y, Ikeda, R, Miura, K, Taki, S, Higuchi, T, Tonami, H & Yamamoto, I 2004, '11C-acetate PET imaging of lung cancer: Comparison with 18F-FDG PET and 99mTc-MIBI SPET', European Journal of Nuclear Medicine and Molecular Imaging, vol. 31, no. 1, pp. 13-21. https://doi.org/10.1007/s00259-003-1326-7
Higashi, Kotaro ; Ueda, Yoshimichi ; Matsunari, Ichiro ; Kodama, Yuko ; Ikeda, Ryosuke ; Miura, Katsuyuki ; Taki, Suzuka ; Higuchi, Takahiro ; Tonami, Hisao ; Yamamoto, Itaru. / 11C-acetate PET imaging of lung cancer : Comparison with 18F-FDG PET and 99mTc-MIBI SPET. In: European Journal of Nuclear Medicine and Molecular Imaging. 2004 ; Vol. 31, No. 1. pp. 13-21.
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AU - Kodama, Yuko

AU - Ikeda, Ryosuke

AU - Miura, Katsuyuki

AU - Taki, Suzuka

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N2 - Recently carbon-11 acetate (AC) positron emission tomography (PET) has been reported to be of clinical value for the diagnosis of cancer that is negative on fluorine-18 fluorodeoxyglucoce (FDG) PET. We investigated the uptake of AC in lung cancer to determine whether this tracer is of potential value for tumour detection and characterisation, and to compare AC PET imaging with FDG PET and technetium-99m sestamibi (MIBI) single-photon emission tomography (SPET). Twenty-three patients with 25 lung cancers underwent AC and FDG PET. Twenty of 23 patients were also investigated with MIBI SPET. Dynamic images were acquired for 26 min after the injection of 555 MBq of AC. Standardised uptake values (SUVs) and/or tumour to non-tumour activity ratios (T/N) for each tumour were investigated at 10-20 min after AC administration, 40-60 min after administration of 185 MBq FDG and 15-45 min after administration of 555 MBq MIBI. Twenty lung cancers were resected surgically, and the degree of tracer uptake in the primary lesion was correlated with histopathological features (cell dedifferentiation and aggressiveness) and prognosis. Rapid uptake of AC followed by extremely slow clearance was observed. For the purpose of tumour identification, AC PET was inferior to FDG PET in 8 of 25 (32%) lung cancers, and the T/N of AC was lower than that of FDG. However, AC PET was superior to FDG PET in the identification of a slow-growing tumour (bronchiolo-alveolar carcinoma). There was a positive correlation between AC uptake (T/N) and MIBI uptake (T/N) (r=0.799, P<0.0001). A positive correlation was not observed between either AC or MIBI uptake and the degree of cell dedifferentiation in lung adenocarcinomas, whereas FDG uptake did correlate with the degree of cell dedifferentiation. In lung adenocarcinoma, there was a weak correlation between aggressiveness and FDG uptake, but no correlation was evident for AC and MIBI. In addition, a positive correlation was not observed between AC or MIBI uptake and postoperative recurrence in lung adenocarcinoma, whereas FDG uptake did correlate with postoperative recurrence. Thus, the greater the FDG uptake, the higher the malignant grade. In conclusion, for the purpose of tumour identification, AC PET was inferior to FDG PET but superior to MIBI SPET. Neither AC nor MIBI uptake reflects the malignant grade in lung adenocarcinoma, whereas FDG uptake does. AC PET is less diagnostically informative than FDG PET in patients with lung cancer. However, AC PET may play a complementary role in the identification of low-grade malignancies that are not FDG avid.

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