18F-FMT uptake seen within primary cancer on PET helps predict outcome of non-small cell lung cancer.
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.
Kaira
Kyoichi
K
Department of Medicine and Molecular Science, Gunma University Graduate School of Medicine, Showa-machi, Maebashi, Gunma, Japan. kkaira1970@yahoo.co.jp
Oriuchi
Noboru
N
Shimizu
Kimihiro
K
Tominaga
Hideyuki
H
Yanagitani
Noriko
N
Sunaga
Noriaki
N
Ishizuka
Tamotsu
T
Kanai
Yoshikatsu
Y
Mori
Masatomo
M
Endo
Keigo
K
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*
D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D019805:alpha-Methyltyrosine