Abstract:Objective To investigate the application value of fluorine-18 fluorodeoxyglucose （18F-FDG）- positron emission tomography （PET） in patients with esophageal cancer. Methods From October 1999 to December 2005, 52 patients with esophageal cancer （15 untreated and 37 treated patients） were imaged with 18F-FDG-PET.18F-FDG-PET scans were analyzed by visual method combined with semiquantitative analysis. 18F-FDG- PET results were compared with pathological results and follow-up survey. Results There were 15 untreated patients before 18F-FDG-PET scans, the primary tumors in 11 patients （T2 to T4 stage） were all 18F-FDG avid and primary site in 4 patients （T1 stage） showed nothing abnormal. The sensitivity of 18F-FDG-PET was 73.3% （11/ 15）. In diagnosing 16 resected enlarged lymph nodes beyond 1 cm in 8 operated patients. Six lymph nodes was malignant by 18F-FDG-PET scans before operation, there were 5 metastases lymph nodes and 1 tuberculosis nodes. 18F-FDG-PETrevealed distant metastases in 7 patients and corrected them from surgery candidates to late stage. In 37 treated patients 18F-FDG-PET confirmed 34 patients with recurrence and/or metastasis. Conclusion ^18F-FDG-PET has limited value in comfirming T and N stage in esophageal cancer. It shows much value in M stage and treatment guiding in patients with esophageal cancer.
Objective To investigate the characteristic of the expression of facilitative glucose transporter 1 （Glut1） in bronchial aveolar carcinoma （BAC） and the relationship between expression of Glutl and fluorine-18 fluorodeoxyglucose （18F-FDG） uptake. Methods Twenty patients with BAC were imaged with 18F-FDG positron emission tomography （PET） before surgery. Maximum standard uptake value （SUVmax） and mean standard uptake value （SUVmean ） of tumor and standard uptake value of normal lung （SUVIung） were measured. The expression of Glutl was studied in paraffin sections by streptavidin peroxidase （SP） immunohistochemistry. Results All tumors of the patients could be detected by ^18F-FDG-PET. 18F-FDG uptake of tumor was higher than that of normal lung （SUV SUV and SUVlong were 3.09± 1.35, 2.37±1.03 and 0.39±0.09 respectively）. The expression of Glutl were positive in all tumors （73. 8%± 14. 8% of positive cell rate, 2. 8 ± 0. 9 grade of staining intensity）. Predominantly cytoplasm positive with weak staining intensity were observed in many tumors. Glutl negtive were observed in normal bronchial and lung parenchyma. Positive correlations were found among 18F-FDG uptake, Glut1 expression and tumor size （P〈0. 01）. Conclusion Glutl expression with peculiarity in BAC is correlate with 18F-FDG uptake.
The main purpose of this study is to evaluate the clinical value of 18F-fluorodeoxyglucose (18F-FDG) metabolism imaging in accurate staging and prognosis prediction before treatment of cervical cancer. 18F-FDG single photon emission computed tomography (SPECT/CT) was performed before treatment on 27 patients with cervical cancer and was analyzed retrospectively. All the images were analyzed by image fusion software. Meanwhile, primary tumor size and T/B, lymph nodes size and T/B were measured by software. Comparison of the relationship between primary tumor T/B of cervix and clinic pathological factors was performed using SPSS17.0. The diagnosis was established according to pathology results of surgery or/and multi-modalities of imaging and clinical following up. The results showed that the primary tumor T/B value of cervix was 5.9 (3.2). With the increased clinical stage, T/B of primary tumor value was significantly increased (P<0.05). The T/B value in patients ≥Ⅱa stage was significantly higher than those of ≤Ⅰb stage. There were no significant correlations between T/B value and primary tumor size, lymph-node metastasis, and histological type (P>0.05). Thirteen lymph nodes were detected by 18F-FDG imaging in 27 patients with cervical cancer. For diagnosing lymph nodes metastasis, the sensitivity, specificity, accuracy, positive and negative predictive value by 18F-FDG imaging were 75.0%, 78.9%, 77.8%, 60.0% and 88.2%, respectively. The T/B value of all lymph nodes was 6.3 (3.5), in which T/B value of distant metastasis was significantly higher than that of the pelvic metastasis (P<0.05). There were no significant correlations between T/B value and the size of lymph nodes (P>0.05). Uterine body uptaking FDG were discovered in 17 patients and 15 cases were then pathologically proved. Two of 15 cases were cancerous invasion of uterine body, and the other 13 cases were physiological changes of endometrial, and the T/B value of the former was significantly higher than that of the latter (P<0.05). There were positive correlation between invasion of uterine body and lymph nodes metastasis (P<0.05). In conclusion, 18F-FDG imaging has an obvious value for the diagnosis of outside pelvic and distant lymph node metastasis, uterine body infiltrated, and accurate staging. Primary focal T/B value of cervical cancer associates with the clinical stage, which can reflect the risk of patients, and were useful to preliminarily predict the prognosis of cervical cancer.
Non-small cell lung cancer (NSCLC) accounts for more than 80% of lung cancer. Nowadays, gemcitabine and cisplatin in combination have been adopted as the first-line chemotherapy for patients with NSCLC. This study aimed to monitor early response to combined chemotherapy of gemcitabine plus cisplatin in a mouse model of NSCLC by using 18F-fluorodeoxyglucose and 18F-fluorothymidine small animal positron emission tomography (PET). Lewis lung carcinoma-bearing C57BL/6 mice were treated with gemcitabine-cisplatin or saline. Small animal PET with 18F-FDG and 18F-FLT was performed before (baseline) and after treatment (on Day 3), respectively. Imaging results were confirmed by histopathological studies (hematoxylin and eosin staining, Ki67 staining). Compared to the results in the control group, gemcitabine-cisplatin in the treated group significantly inhibited tumor growth (P<0.05). In the treated group, the maximum standardized uptake value (SUVmax) of 18F-FLT decreased significantly from 0.59±0.05 (baseline) to 0.28±0.05 (Day 3) (P<0.05). There was no significant difference between baseline (4.35±0.46) and that on Day 3 (4.02±0.47) on 18F-FDG SUVmax (P>0.05). The proliferation of tumor assessed by Ki67 staining decreased significantly after treatment of one dose of gemicitabine-cisplatin (P<0.05). The staining of HE showed an increase in necrotic and inflam- matory cells after the treatment. This study demonstrated that the uptake of 18F-FLT reduced more rapidly and signi-ficantly than that of 18F-FDG and was less disturbed by the increase of inflammatory cells after chemotherapy.
Because of the unobvious early symptoms and low 5-year survival rate, the early diagnosis and treatment is of great significance for patients with non-small cell lung cancer. Glucose transporter-1 is the most widely distributed glucose transporters in various tissue cells in the human body, whose expression in non-small cell lung cancer is closely related to the histological types, lymph node metastasis, degree of differentiation, progression and prognosis.18F-FDG PET/CT imaging, a molecular imaging diagnostic method, is based on the characteristics of glucose metabolism in malignant tumors, which has been widely applied in the cancer diagnosis, stage division, evaluation of therapeutic effects and prognosis evaluation. Glucose transporter-1 is regulated and influenced by many factors, and it is closely related to 18F-FDG PET/CT imaging. This article briefly reviews the progress in the clinical application and correlation between glucose transporter-1 and 18F-FDG PET/CT imaging for non-small cell lung cancer, in order to improve the diagnosis and treatment of lung cancer.