Sensitivity of FDG PET, GLUT1 expression and proliferative index in bronchioloalveolar lung cancer.
OBJECTIVE
To estimate the sensitivity of [F] fluorodeoxyglucose (FDG) positron emission tomography (PET) and to assess the expression of glucose transporter 1 (GLUT1) and proliferative index (PI) in bronchioloalveolar lung cancer (BAC).


METHODS
Twenty-four patients with resected BAC underwent preoperative PET between October 1996 and February 2003. The surgical specimens were re-examined, and 18 patients who fulfilled the 1999 WHO definition for BAC were included in the study. The PET images were reviewed in order to determine the positive (PET+) and negative (PET-) tumours on PET. The pathology slides were stained with antibodies to GLUT1 and Proliferating cell nuclear antigen (PCNA) in order to determine GLUT1 expression and PI, respectively.


RESULTS
There were 13 cases of PET+ BAC (sensitivity, 72%; confidence interval, 52-93%); seven of them were GLUT1+ cases and six were GLUT1-. The stromal cell PI was significantly higher in GLUT1+ BAC compared to GLUT- BAC (50.9+/-17.1 vs. 33.2+/-14.2, P=0.0286), and higher in PET+ BAC compared to PET- BAC (45.5+/-15.3 vs. 29.6+/-19.6, P=0.0854).


CONCLUSIONS
After applying the 1999 WHO criteria, the sensitivity of PET for detecting BAC is still relatively low. Other glucose transporters such as GLUT3 likely play a role in FDG uptake in BAC. GLUT1+ or PET+ BAC tumours have a higher stromal cell PI when compared to GLUT1- BAC or PET- BAC tumours, respectively.
Khandani
Amir H
AH
Department of Nuclear Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, New York, USA. khandani@med.unc.edu
Whitney
Kathleen D
KD
Keller
Steven M
SM
Isasi
Carmen R
CR
Donald Blaufox
M
M
D001984:Bronchial Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D049109:Cell Proliferation; D002586:Cesium; D004847:Epithelial Cells / Q000473:pathology; D019788:Fluorodeoxyglucose F18; D051272:Glucose Transporter Type 1 / Q000096:biosynthesis* / Q000235:genetics; D006801:Humans; D008168:Lung / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics; D049268:Positron-Emission Tomography; D018809:Proliferating Cell Nuclear Antigen / Q000096:biosynthesis / Q000235:genetics; D019275:Radiopharmaceuticals; D017154:Stromal Cells / Q000473:pathology; D014057:Tomography, X-Ray Computed
D051272:Glucose Transporter Type 1; D018809:Proliferating Cell Nuclear Antigen; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002586:Cesium