title: Value of 11C-choline PET/CT for lung cancer diagnosis and the relation             between choline metabolism and proliferation of cancer cells.
abstract: The aim of this study was to investigate the efficacy of 11C-choline PET/CT             imaging for lung cancer and the correlation between choline uptake of lung cancer             tissue and the expression of choline kinase (ChoK), phosphorylcholine-cytidyl             transferase and Ki-67 index. Between March 2008 and June 2010, 53 patients diagnosed             or suspected of having lung cancer underwent integrated 11C-choline PET/CT and             contrast-enhanced CT scans before surgery. After surgery, specimens from 42 patients             diagnosed with lung cancer were used to detect the expression of ChoK, phosphorylcholine-cytidyl             transferase and the Ki-67 index. The PET/CT results were analyzed using visual             methods and the standardized uptake value (SUV) of lesions was measured using             semi-quantitative methods. Finally, the analyzed results were compared to the             histopathological results. The accuracy of the 11C-choline PET/CT for diagnosing             lung cancer was 81.13% (43/53), compared with 71.70% (38/53) for CT scanning.             The difference was not statistically significant (P=0.61). The accuracy of 11C-choline             PET/CT for diagnosing lymph nodes was 83.76% (227/271), compared with 66.79% (181/271)             for CT scanning. This difference was statistically significant (P=0.04); the SUVmean             value of lesions correlated positively with the Ki-67 index (r=0.51, p=0.002).             Of the 35 patients with positive 11C-choline PET results, 29 (82.86%) overexpressed             ChoK, 26 (74.29%) overexpressed phosphorylcholine-cytidyl transferase. The seven             patients with negative 11C-choline PET results did not exhibit overexpression             of ChoK or phosphorylcholine-cytidyl transferase; the SUVmean value correlated             positively with the expression of both ChoK and phosphorylcholine-cytidyl transferase             (r=0.52, p=0.001; r=0.37, p=0.029). In conclusion, compared with contrast-enhanced             CT, 11C-choline PET offers nodal staging with higher accuracy. The SUV value of             PET is correlated with the proliferation of tumor cells and the mechanism of PET             imaging is associated with the overexpression of ChoK and phosphorylcholine-cytidyl             transferase.
authors.affiliation: Department of Thoracic Surgery, Provincial Hospital Affiliated to Shandong University, Shandong University, Jinan, Shandong 250021, PR China.
authors.forename: Meng
authors.initials: M
authors.lastname: Li
authors.forename: Zhongmin
authors.initials: Z
authors.lastname: Peng
authors.forename: Qingwei
authors.initials: Q
authors.lastname: Liu
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Shuzhan
authors.initials: S
authors.lastname: Yao
authors.forename: Qi
authors.initials: Q
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000378:metabolism; D000328:Adult; D000368:Aged; D002250:Carbon Radioisotopes; D018287:Carcinoma, Large Cell / Q000175:diagnosis / Q000378:metabolism; D018278:Carcinoma, Neuroendocrine / Q000175:diagnosis / Q000378:metabolism; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis / Q000378:metabolism; D049109:Cell Proliferation; D002794:Choline / Q000378:metabolism*; D002797:Choline Kinase / Q000378:metabolism; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000378:metabolism; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D011379:Prognosis; D019275:Radiopharmaceuticals; D055752:Small Cell Lung Carcinoma / Q000175:diagnosis / Q000378:metabolism; D014057:Tomography, X-Ray Computed
chemical_list: D002250:Carbon Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002797:Choline Kinase; D002794:Choline