title: 18F-FMT uptake seen within primary cancer on PET helps predict outcome of non-small cell lung cancer.
abstract: L-[3-(18)F]-alpha-methyl tyrosine ((18)F-FMT) is an amino-acid tracer for PET imaging. We evaluated the prognostic significance of (18)F-FMT PET in patients with non-small cell lung cancer.
  
  
  METHODS
  Ninety-eight patients (80 men and 18 women; age range, 42-82 y; median age, 69 y) with stage I-IV non-small cell lung cancer were enrolled in this study. They included 57 with adenocarcinoma, 31 with squamous cell carcinoma, 5 with large cell carcinoma, and 5 with other conditions. The median follow-up duration was 17.0 mo. A pair of PET studies with (18)F-FMT and (18)F-FDG was performed, and tracer uptake by the primary tumor was evaluated using the maximal standardized uptake value (SUV(max)). Overall survival and disease-free survival were calculated by the Kaplan-Meier method. The prognostic significance was assessed by univariate and multivariate analyses.
  
  
  RESULTS
  The best discriminative SUV(max) cutoffs for (18)F-FMT and (18)F-FDG in the primary tumors were 1.6 and 11, respectively. In the univariate analysis, a high SUV(max) was significant in predicting poor overall survival for (18)F-FMT (P = 0.0129) and (18)F-FDG PET (P = 0.0481). According to histologic types, (18)F-FMT and (18)F-FDG uptake were a stronger prognostic predictor in adenocarcinoma than in nonadenocarcinomatous disease. Patients with a high SUV(max) for (18)F-FMT showed significantly worse disease-free survival rates than those with a low SUV(max), and multivariate analysis confirmed that a high SUV(max) for (18)F-FMT was an independent and significant factor in predicting a poor prognosis in patients with adenocarcinoma (P = 0.0191).
  
  
  CONCLUSIONS
  Uptake of (18)F-FMT in primary tumors was an independent prognostic factor in patients with pulmonary adenocarcinoma.
authors.affiliation: Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, Japan. kkaira1970@yahoo.co.jp
authors.forename: Kyoichi
authors.initials: K
authors.lastname: Kaira
authors.forename: Noboru
authors.initials: N
authors.lastname: Oriuchi
authors.forename: Kimihiro
authors.initials: K
authors.lastname: Shimizu
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Tominaga
authors.forename: Noriko
authors.initials: N
authors.lastname: Yanagitani
authors.forename: Noriaki
authors.initials: N
authors.lastname: Sunaga
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Ishizuka
authors.forename: Yoshikatsu
authors.initials: Y
authors.lastname: Kanai
authors.forename: Masatomo
authors.initials: M
authors.lastname: Mori
authors.forename: Keigo
authors.initials: K
authors.lastname: Endo
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000378:metabolism / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D005260:Female; D005462:Fluorine Radioisotopes / Q000737:chemistry*; D019788:Fluorodeoxyglucose F18 / Q000378:metabolism; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000378:metabolism* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D049268:Positron-Emission Tomography; D011379:Prognosis; D015996:Survival Rate; D019805:alpha-Methyltyrosine / Q000737:chemistry* / Q000378:metabolism*
chemical_list: D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D019805:alpha-Methyltyrosine