title: Clinical significance of ¹⁸F-α-methyl tyrosine PET/CT for the detection of bone marrow invasion in patients with oral squamous cell carcinoma: comparison with ¹⁸F-FDG PET/CT and MRI.
abstract: OBJECTIVE
  L-3-[(18)F]-fluoro-α-methyl tyrosine ((18)F-FAMT) is an amino acid tracer for positron emission tomography/computed tomography (PET/CT) which specifically transported into cancer cells by L-type amino acid transporter 1 (LAT1). LAT1 overexpression in tumors is significantly correlated with cell proliferation and angiogenesis. (18)F-FAMT PET/CT, fluorine-18-fluorodeoxyglucose ((18)F-FDG) PET/CT and magnetic resonance imaging (MRI) were compared for their diagnostic performance in the detection of bone marrow invasion in patients with oral squamous cell carcinoma (OSCC).
  
  
  METHODS
  Twenty-seven patients with OSCC on the upper or lower alveolar ridge underwent staging by MRI, (18)F-FDG PET/CT and (18)F-FAMT PET/CT studies before surgery. Post-surgical pathologic examination was used as the standard to determine the final diagnoses. The possibility of bone marrow invasion on MRI, (18)F-FDG PET/CT and (18)F-FAMT PET/CT were usually graded retrospectively into five-point score. Sensitivity, specificity, accuracy, positive predictive value (PPV) and negative predictive value (NPV) were calculated according to the obtained scores.
  
  
  RESULTS
  As the sensitivity of (18)F-FDG PET/CT was highest (100 %) among that of MRI (95 %) and (18)F-FAMT PET/CT (90 %), the specificity of (18)F-FAMT PET/CT was highest (85.7 %) among that of MRI (57 %) and (18)F-FDG PET/CT (14.3 %). The size of pathological tumor was accorded with that detected by (18)F-FAMT PET/CT and was smaller than that detected by (18)F-FDG PET/CT (P < 0.01). Significant difference was not found between (18)F-FAMT PET tumor volume and pathological tumor volume.
  
  
  CONCLUSIONS
  (18)F-FAMT PET/CT was useful and more specific than MRI or (18)F-FDG PET/CT in the detection of bone marrow invasion of OSCC and may contribute to minimize the extent of resection in oral surgery patient.
authors: Department of Stomatology and Maxillofacial Surgery, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan. kimmu@gunma-u.ac.jp
authors: Mai
authors: M
authors: Kim
authors: Tetsuya
authors: T
authors: Higuchi
authors: Yukiko
authors: Y
authors: Arisaka
authors: Arifudin
authors: A
authors: Achmad
authors: Azusa
authors: A
authors: Tokue
authors: Hideyuki
authors: H
authors: Tominaga
authors: Go
authors: G
authors: Miyashita
authors: Hidetaka
authors: H
authors: Miyazaki
authors: Akihide
authors: A
authors: Negishi
authors: Satoshi
authors: S
authors: Yokoo
authors: Yoshito
authors: Y
authors: Tsushima
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D019046:Bone Marrow Neoplasms / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D005462:Fluorine Radioisotopes; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D064847:Multimodal Imaging / Q000379:methods*; D049268:Positron-Emission Tomography; D019275:Radiopharmaceuticals; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014443:Tyrosine / Q000031:analogs & derivatives*
chemical_list: D005462:Fluorine Radioisotopes; D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; C105990:2-fluoro-alpha-methyltyrosine; D014443:Tyrosine