ナガシマ ヨウジ   Nagashima, Yoji
  長嶋 洋治
   所属   医学部 医学科(東京女子医科大学病院)
   職種   教授
論文種別 原著
言語種別 英語
査読の有無 査読あり
表題 Comparison of (11)C-4DST and (18)F-FDG PET/CT imaging for advanced renal cell carcinoma: preliminary study.
掲載誌名 正式名:Abdominal Radiology
略  称:Abd Radiol
掲載区分国外
巻・号・頁 41(3),521-530頁
著者・共著者 Minamimoto R, Nakaigawa N, Nagashima Y, Toyohara J, Ueno D, Namura K, Nakajima K, Yao M, Kubota K
発行年月 2016/03
概要 PURPOSE: 4'-[Methyl-(11)C]-thiothymidine (4DST) has been developed as an in vivo
cell proliferation marker based on its DNA incorporation mechanism. This study
evaluated the potential of 4DST PET/CT for imaging cellular proliferation in
advanced clear cell renal cell carcinoma (RCC), compared with FDG PET/CT. Both
4DST and FDG uptake were compared with biological findings based on surgical
pathology.
METHODS: Five patients (3 men and 2 women; mean (±SD) age 64.8 ± 11.0 years) with
a single RCC (mean diameter: 9.3 ± 3.2 cm) were examined by PET/CT using 4DST and
FDG. The dynamic emission scan of 4DST for RCC over 35 min followed by a static
emission scan of the body for 4DST and FDG. Then we compared the maximum
standardized uptake value (SUVmax) of 20 areas of RCC on both 4DST and FDG images
with (1) the Ki-67 index of cellular proliferation (2) Fuhrman grade system for
nuclear grade (G) in RCC and (3) pathological phosphorylated grade of mammalian
target of rapamycin (pmTOR).
RESULTS: All patient cases showed clear uptake of FDG and 4DST in RCC tumors,
with mean 4DST SUVmax of 7.3 ± 2.2 (range 4.3-9.4) and mean FDG SUVmax of
6.0 ± 2.8 (range 3.4-10.4). The correlation coefficient between SUVmax and Ki-67
index was higher with 4DST (r = 0.61) than with FDG (r = 0.43). Tumor 4DST uptake
(G0: 1.4, G2: 2.6, G2 5.6, G4: 5.7) and tumor FDG uptake (G0: 1.8, G2: 2.9, G2
3.7, G4: 4.1) were both related to Fuhrman grade system. The 4DST uptake
increased as the pmTOR grade increases (G0: 3.1, G1: 4.8, G2: 4.7, G3: 6.2); in
contrast FDG uptake was unrelated to pmTOR grade (G0: 2.8, G2: 4.0, G2 3.3, G4:
3.6).
CONCLUSION: A higher correlation with the proliferation of RCC was observed for
4DST than for FDG. The 4DST uptake exhibits the possibility to predict pmTOR
grade, indicating that 4DST has potential for the evaluation of therapeutic
effect with mTOR inhibitor in patients with RCC.