title: [18F]5-fluoro-2-deoxyuridine-PET for imaging of malignant tumors and for measuring tissue proliferation.
abstract: The nucleoside 5-fluoro-2-deoxyuridine is a pyrimidine analogue accumulating in proliferative cells. We prospectively evaluated biodistribution of the PET tracer [(18)F]5-fluoro-2-deoxyuridine (FdUrd), its value for imaging malignant tumors, and its correlation to both [(18)F]2-fluoro-2-deoxyglucose (FDG)-PET findings and histological proliferation indices. In 11 previously untreated patients (5 lung carcinoma; 3 soft tissue sarcoma; 2 gastrointestinal carcinoma; 1 non-Hodgkin lymphoma [NHL]), mean doses of 290 MBq FdUrd and 390 MBq FDG were administered intravenously on subsequent days. Static PET scans were initiated 50-70 min after administration and the mean standardized uptake values (SUV) were calculated. Dynamic emission FdUrd scans were performed in 8/11 patients. Time-activity curves of blood and tumors as well as SUV of tumor lesions and organs were calculated. Proliferative activity was evaluated by Ki-67 immunohistostaining of biopsies. Tracer accumulated physiologically in liver, kidney, and bladder. SUVs were: kidney, 4.8 +/- 0.66; liver, 4.1 +/- 0.36; vertebrae, 0.70 +/- 0.17; spleen, 0.37 +/- 0.06; lungs, 0.19 +/- 0.05; femora/humeri, 0.14 +/- 0.03. Five patients exhibited significant intratumoral FdUrd-uptake (2 sarcomas; 1 NHL; 2 lung carcinomas) with mean SUVs ranging from 0.7 to 10.5. Metastases were not detected. Time-activity curves showed a rapid initial increase of intratumoral activity followed by activity retention. FDG-PET was positive in 10/11 patients. Correlation between the SUV of FdUrd-PET and FDG-PET or the tissue proliferation index, respectively, was not significant. FdUrd was a suitable tracer for imaging malignant tumors only in exceptional cases: Sarcoma, NHL, and some lung carcinomas were detected. FdUrd-PET was less effective than FDG-PET. In this group of patients, it was not useful in measuring tissue proliferation.
authors.affiliation: Abteilung für Nuklearmedizin, Universittskliniken Ulm, Germany. buchmann@nuklear.klinik.uni-mainz.de
authors.forename: Inga
authors.initials: I
authors.lastname: Buchmann
authors.forename: Andreas T J
authors.initials: AT
authors.lastname: Vogg
authors.forename: Gerhard
authors.initials: G
authors.lastname: Glatting
authors.forename: Stefan
authors.initials: S
authors.lastname: Schultheiss
authors.forename: Peter
authors.initials: P
authors.lastname: Möller
authors.forename: Frank
authors.initials: F
authors.lastname: Leithäuser
authors.forename: Michael
authors.initials: M
authors.lastname: Schulte
authors.forename: Wilfried
authors.initials: W
authors.lastname: Gfrörer
authors.forename: Jörg
authors.initials: J
authors.lastname: Kotzerke
authors.forename: Sven N
authors.initials: SN
authors.lastname: Reske
mesh_terms: D000328:Adult; D000368:Aged; D001842:Bone and Bones / Q000378:metabolism; D002455:Cell Division / Q000187:drug effects; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D007668:Kidney / Q000378:metabolism; D008099:Liver / Q000378:metabolism; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000378:metabolism; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D009369:Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism; D011446:Prospective Studies; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics*; D012509:Sarcoma / Q000000981:diagnostic imaging / Q000378:metabolism; D014018:Tissue Distribution; D014055:Tomography, Emission-Computed / Q000379:methods; D001743:Urinary Bladder / Q000378:metabolism
chemical_list: D019394:Ki-67 Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18