title: 11C-Acetate can be used in place of 18F-fluorodeoxyglucose for positron emission tomography imaging of non-small cell lung cancer with higher sensitivity for well-differentiated adenocarcinoma.
abstract: OBJECTIVE
  Although positron emission tomography (PET) using F-fluorodeoxy-glucose (FDG) frequently gives false-negative results for slow-growing tumors, C-acetate (AC)-PET has been reported to be able to detect them. To determine the usefulness of AC-PET for imaging non-small cell lung cancers (NSCLCs), the sensitivity and specificity were compared between the AC-PET and FDG-PET with a multicenter study.
  
  
  METHODS
  A total of 284 pulmonary lesions (227 NSCLCs and 57 benign lesions) were examined using both AC-PET and FDG-PET before surgery at seven Japanese institutes. The AC- or FDG-uptake in each lesion were quantitatively measured using the contrast ratio of the standard uptake value between the lesions and the contralateral lung.
  
  
  RESULTS
  The sensitivity of AC-PET for diagnosing NSCLC was 0.71, which was significantly higher than the value of 0.57 obtained by FDG-PET (p < 0.001). No significant difference in the specificity was seen between AC- and FDG-PET. For the 146 well-differentiated adenocarcinomas, the sensitivity of AC-PET was 0.62, which was significantly higher than the value of 0.37 obtained by FDG-PET (p < 0.001). Of the 51 moderately- or poorly-differentiated adenocarcinomas and 30 nonadenocarcinomas, there was no significant difference of sensitivity between AC- and FDG-PET.
  
  
  CONCLUSIONS
  AC-PET could be used in place of FDG-PET for imaging NSCLC, with higher sensitivity for well-differentiated adenocarcinoma compared with FDG-PET.
authors.affiliation: Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan. hnomori@qk9.so-net.ne.jp
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nomori
authors.forename: Hidekatsu
authors.initials: H
authors.lastname: Shibata
authors.forename: Kimiichi
authors.initials: K
authors.lastname: Uno
authors.forename: Kenichi
authors.initials: K
authors.lastname: Iyama
authors.forename: Yumi
authors.initials: Y
authors.lastname: Honda
authors.forename: Rumi
authors.initials: R
authors.lastname: Nakashima
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sakaguchi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Goya
authors.forename: Iwao
authors.initials: I
authors.lastname: Takanami
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Koizumi
authors.forename: Takashi
authors.initials: T
authors.lastname: Suzuki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kaji
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Horio
mesh_terms: D000085:Acetates; D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000556:secondary; D002244:Carbon; D002250:Carbon Radioisotopes; D002289:Carcinoma, Non-Small-Cell Lung / Q000000981:diagnostic imaging* / Q000556:secondary; D002294:Carcinoma, Squamous Cell / Q000000981:diagnostic imaging / Q000556:secondary; D002454:Cell Differentiation; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D008207:Lymphatic Metastasis; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography / Q000379:methods*; D011446:Prospective Studies; D012372:ROC Curve; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed
chemical_list: D000085:Acetates; D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; C438206:carbon-11 acetate; D019788:Fluorodeoxyglucose F18; D002244:Carbon