18F-FDG-PET of musculoskeletal tumors: a correlation with the expression of glucose transporter 1 and hexokinase II.
OBJECTIVE
It remains controversial whether positron emission tomography (PET) with 2-deoxy-2-[F-18]fluoro-D-glucose (F-18-FDG) can differentiate between benign and malignant musculoskeletal tumors. To uncover the mechanism of F-18-FDG accumulations, we analyzed the correlation between the F-18-FDG accumulation and the expression of glucose transporter 1 (Glut-1) and hexokinase II (HK-II) in benign and malignant musculoskeletal tumors.


METHODS
The maximum standardized uptake values (SUVmax) of F-18-FDG in 24 benign and 26 malignant musculoskeletal tumors were compared with the histologic malignancies, and the expression of Glut-1 and HK-II was analyzed by immunohistochemistry.


RESULTS
The SUVmax for malignant tumors (6.33+/-4.79) was significantly higher than those with benign tumors (3.47+/-3.12, P<0.01). The expression of Glut-1 was high in 12 patients (all malignant) and low in 38 patients (24 benign and 14 malignant), and the expression of HK-II was high in 36 patients (11 benign and 25 malignant) and low in 14 patients (13 benign and 1 malignant). Cases with high expression of Glut-1 and HK-II at immunohistochemistry showed a higher SUVmax than those with low expression (Glut-1 8.03+/-5.10 and 3.98+/-3.53, P<0.01; HK-II 5.73+/-4.49 and 2.99+/-3.02, P<0.01). No significant dividing threshold of the SUVmax of F-18 FDG was found for the differential diagnosis between benign and malignant tumors or for the expression of Glut-1 and HK-II.


CONCLUSIONS
The limited capability of F-18 FDG-PET in the differential diagnosis of musculoskeletal tumors is owing partly to the various levels of Glut-1 and HK-II expression in individual tumors.
Hamada
Kenichiro
K
Department of Orthopedic Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Tomita
Yasuhiko
Y
Qiu
Ying
Y
Zhang
Binglin
B
Ueda
Takafumi
T
Myoui
Akira
A
Higuchi
Ichiro
I
Yoshikawa
Hideki
H
Aozasa
Katsuyuki
K
Hatazawa
Jun
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001859:Bone Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D002648:Child; D005260:Female; D019788:Fluorodeoxyglucose F18 / Q000493:pharmacokinetics*; D051272:Glucose Transporter Type 1 / Q000378:metabolism*; D006593:Hexokinase / Q000378:metabolism*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019042:Muscle Neoplasms / Q000000981:diagnostic imaging* / Q000378:metabolism*; D049268:Positron-Emission Tomography / Q000379:methods; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013223:Statistics as Topic; D055815:Young Adult
D051272:Glucose Transporter Type 1; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D006593:Hexokinase