Measurement of perfusion in stage IIIA-N2 non-small cell lung cancer using H(2)(15)O and positron emission tomography.
OBJECTIVE
As the interest in antiangiogenesis therapy in oncology is rising, the need for in vivo techniques to monitor such therapy is obvious. Measurement of tumor perfusion using positron emission tomography and H(2)(15)O potentially is such a technique. The objective of the present study was to assess whether it is feasible to measure perfusion in vivo in non-small cell lung cancer (NSCLC) using H(2)(15)O and positron emission tomography.


METHODS
Fifteen dynamic H(2)(15)O and [(18)F]2-fluoro-2-deoxy-D-glucose ((18)FDG) studies were performed in 10 patients with stage IIIA-N2 NSCLC. Blood flow (BF) data were correlated with simplified methods of analysis (tumor:normal tissue ratio and standardized uptake value) and with glucose metabolism (MR(glu)).


RESULTS
(18)FDG data were required for accurate definition of tumor and mediastinal lymph node metastases. There was large intertumor variation in BF. Correlation of simplified methods of analysis with quantitative BF was poor. In addition, BF and MR(glu) were not correlated.


CONCLUSIONS
Measurement of BF in NSCLC using H(2)(15)O and (18)FDG is feasible. Simple uptake analysis, however, cannot be used as an indicator of perfusion. Whether BF can be used for response monitoring needs to be evaluated in a large patient study, where results can be compared with outcome.
Clinical PET Centre and Departments of Pulmonary Medicine, VU University Medical Centre, 1007 MB Amsterdam, the Netherlands.
Corneline J
CJ
Hoekstra
Sigrid G
SG
Stroobants
Otto S
OS
Hoekstra
Egbert F
EF
Smit
Johan F
JF
Vansteenkiste
Adriaan A
AA
Lammertsma
D000328:Adult; D000368:Aged; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002289:Carcinoma, Non-Small-Cell Lung / Q000098:blood supply* / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000098:blood supply* / Q000000981:diagnostic imaging; D008198:Lymph Nodes; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009389:Neovascularization, Pathologic / Q000000981:diagnostic imaging*; D010104:Oxygen Radioisotopes; D011379:Prognosis; D014055:Tomography, Emission-Computed; D014867:Water
D000970:Antineoplastic Agents; D010104:Oxygen Radioisotopes; D014867:Water; D019788:Fluorodeoxyglucose F18