[18F]5-fluoro-2-deoxyuridine-PET for imaging of malignant tumors and for measuring tissue proliferation.

Abstract

The nucleoside 5-fluoro-2-deoxyuridine is a pyrimidine analogue accumulating in proliferative cells. We prospectively evaluated biodistribution of the PET tracer [(18)F]5-fluoro-2-deoxyuridine (FdUrd), its value for imaging malignant tumors, and its correlation to both [(18)F]2-fluoro-2-deoxyglucose (FDG)-PET findings and histological proliferation indices. In 11 previously untreated patients (5 lung carcinoma; 3 soft tissue sarcoma; 2 gastrointestinal carcinoma; 1 non-Hodgkin lymphoma [NHL]), mean doses of 290 MBq FdUrd and 390 MBq FDG were administered intravenously on subsequent days. Static PET scans were initiated 50-70 min after administration and the mean standardized uptake values (SUV) were calculated. Dynamic emission FdUrd scans were performed in 8/11 patients. Time-activity curves of blood and tumors as well as SUV of tumor lesions and organs were calculated. Proliferative activity was evaluated by Ki-67 immunohistostaining of biopsies. Tracer accumulated physiologically in liver, kidney, and bladder. SUVs were: kidney, 4.8 +/- 0.66; liver, 4.1 +/- 0.36; vertebrae, 0.70 +/- 0.17; spleen, 0.37 +/- 0.06; lungs, 0.19 +/- 0.05; femora/humeri, 0.14 +/- 0.03. Five patients exhibited significant intratumoral FdUrd-uptake (2 sarcomas; 1 NHL; 2 lung carcinomas) with mean SUVs ranging from 0.7 to 10.5. Metastases were not detected. Time-activity curves showed a rapid initial increase of intratumoral activity followed by activity retention. FDG-PET was positive in 10/11 patients. Correlation between the SUV of FdUrd-PET and FDG-PET or the tissue proliferation index, respectively, was not significant. FdUrd was a suitable tracer for imaging malignant tumors only in exceptional cases: Sarcoma, NHL, and some lung carcinomas were detected. FdUrd-PET was less effective than FDG-PET. In this group of patients, it was not useful in measuring tissue proliferation.

• Authors: Inga Buchmann, Andreas T J Vogg, Gerhard Glatting, Stefan Schultheiss, Peter Möller, Frank Leithäuser, Michael Schulte, Wilfried Gfrörer, Jörg Kotzerke, Sven N Reske
• Journal: Cancer biotherapy & radiopharmaceuticals (Cancer Biother Radiopharm) Vol. 18 Issue 3 Pg. 327-37 (Jun 2003) ISSN: 1084-9785 [Print] United States
• PMID: 12954120 (Publication Type: Comparative Study, Journal Article)

Chemical References

• Ki-67 Antigen
• Radiopharmaceuticals
• Fluorodeoxyglucose F18

Topics

• Adult
• Aged
• Bone and Bones (metabolism)
• Cell Division (drug effects)
• Female
• Fluorodeoxyglucose F18 (pharmacokinetics)
• Gastrointestinal Neoplasms (diagnostic imaging, metabolism)
• Humans
• Ki-67 Antigen (metabolism)
• Kidney (metabolism)
• Liver (metabolism)
• Lung Neoplasms (diagnostic imaging, metabolism)
• Lymphoma, Non-Hodgkin (diagnostic imaging, metabolism)
• Male
• Middle Aged
• Neoplasm Staging (methods)
• Neoplasms (diagnostic imaging, metabolism)
• Prospective Studies
• Radiopharmaceuticals (pharmacokinetics)
• Sarcoma (diagnostic imaging, metabolism)
• Tissue Distribution
• Tomography, Emission-Computed (methods)
• Urinary Bladder (metabolism)