title: Volumetric comparison of positron emission tomography/computed tomography using 4'-[methyl-¹¹C]-thiothymidine with 2-deoxy-2-¹⁸F-fluoro-D-glucose in patients with advanced head and neck squamous cell carcinoma.
abstract: OBJECTIVE
  We prospectively compared the diagnostic value of PET/computed tomography (CT) findings using the tracers 4'-[methyl-11C]-thiothymidine (11C-4DST) and 2-deoxy-2-18F-fluoro-D-glucose (18F-FDG) in patients with head and neck squamous cell carcinoma (HNSCC).
  
  
  METHODS
  Thirty-eight patients with advanced HNSCC underwent 11C-4DST PET/CT and 18F-FDG PET/CT before treatment. Maximum standardized uptake values (SUVmax) were measured for both PET/CT studies; in addition, total lesion glycolysis (TLG) of 18F-FDG PET/CT and total lesion proliferation (TLP) of 11C-4DST PET/CT were measured. Absolute TLG and TLP values as well as values with various SUV thresholds were measured. All patients were followed up for 13.5±7.5 months (mean±SD) to monitor recurrence.
  
  
  RESULTS
  A statistically significant correlation was observed between the primary tumor SUVmax for 11C-4DST PET/CT and 18F-FDG PET/CT (r=0.46, P<0.01). TLP values with SUV thresholds strongly correlated with TLG values relative to the same thresholds (r=0.60-0.92, P<0.001). Nine of the 38 patients with post-treatment recurrence were identified. Receiver operating characteristic curves for TLG3.0 and TLP2.5 showed the highest prognostic ability for recurrence; the sensitivity and specificity of TLG3.0 were 89 and 72%, respectively, and the sensitivity and specificity of TLP2.5 were 89 and 55%, respectively.
  
  
  CONCLUSIONS
  In patients with advanced HNSCC, the TLP of 11C-4DST PET/CT strongly correlated with the TLG of 18F-FDG PET/CT. Although there were no large differences between these values, the receiver operating characteristic curves of the absolute TLG had slightly better prognostic ability for recurrence.
authors.affiliation: aDepartment of Radiology, Division of Nuclear Medicine, National Center for Global Health and Medicine bDepartment of Otolaryngology, Head and Neck Surgery, Juntendo University School of Medicine cResearch Team for Neuroimaging, Tokyo Metropolitan Institute of Gerontology dDepartment of Diagnostic Radiology, Tokyo Metropolitan Geriatric Hospital, Tokyo, Japan.
authors.forename: Kimiteru
authors.initials: K
authors.lastname: Ito
authors.forename: Junkichi
authors.initials: J
authors.lastname: Yokoyama
authors.forename: Yoko
authors.initials: Y
authors.lastname: Miyata
authors.forename: Jun
authors.initials: J
authors.lastname: Toyohara
authors.forename: Momoko
authors.initials: M
authors.lastname: Okasaki
authors.forename: Ryogo
authors.initials: R
authors.lastname: Minamimoto
authors.forename: Miyako
authors.initials: M
authors.lastname: Morooka
authors.forename: Kiichi
authors.initials: K
authors.lastname: Ishiwata
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kubota
mesh_terms: D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D005260:Female; D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D064847:Multimodal Imaging; D049268:Positron-Emission Tomography; D012008:Recurrence; D000077195:Squamous Cell Carcinoma of Head and Neck; D013872:Thionucleosides; D013936:Thymidine / Q000031:analogs & derivatives*; D014057:Tomography, X-Ray Computed; D047368:Tumor Burden
chemical_list: D019394:Ki-67 Antigen; D013872:Thionucleosides; D019788:Fluorodeoxyglucose F18; C070456:4'-thiothymidine; D013936:Thymidine