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.
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.
Nomori
Hiroaki
H
Department of Thoracic Surgery, Graduate School of Medical and Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan. hnomori@qk9.so-net.ne.jp
Shibata
Hidekatsu
H
Uno
Kimiichi
K
Iyama
Kenichi
K
Honda
Yumi
Y
Nakashima
Rumi
R
Sakaguchi
Kazuya
K
Goya
Tomoyuki
T
Takanami
Iwao
I
Koizumi
Kiyoshi
K
Suzuki
Takashi
T
Kaji
Masahiro
M
Horio
Hirotoshi
H
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
D000085:Acetates; D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; C438206:carbon-11 acetate; D019788:Fluorodeoxyglucose F18; D002244:Carbon