You could be reading the full-text of this article now if you...

If you have access to this article through your institution,
you can view this article in

Detection of bronchioloalveolar cancer by means of PET/CT and 18F-fluorocholine, and comparison with 18F-fluorodeoxyglucose

Balogova, Sonaa e; Huchet, Virginiea; Kerrou, Khaldouna; Nataf, Valerieb; Gutman, Fabricea; Antoine, Martinec; Ruppert, Anne-Maried; Prignon, Auréliea; Lavolée, Armelled; Montravers, Francoisea; Mayaud, Charlesd; Cadranel, Jacquesd; Talbot, Jean-Noëla

Nuclear Medicine Communications:
doi: 10.1097/MNM.0b013e3283369654
Original Articles
Abstract

Aim: Bronchioloalveolar (BAC) cancer is a source of false-negative 18F-fluorodeoxyglucose (FDG) PET/computed tomography (CT) results. A few studies reported better diagnostic performances with PET tracers of lipid metabolism, 11C-choline, or 11C-acetate, for the detection of well-differentiated adenocarcinoma or BAC. 18F-fluorocholine (FCH) is a lipid analogue for PET imaging, with advantages in terms of logistics and image resolution. We carried out this prospective pilot study to evaluate whether FCH PET/CT could detect lung cancer with a BAC component and could be more sensitive than FDG in this aim.

Methods: Fifteen patients with a lung nodule or lesion suspected for BAC on CT and/or with a history of BAC had PET/CT 60–90 min after 5 MBq FDG/kg body mass and, on a separate day, 10–20 min after 4 MBq FCH/kg body mass. The standard of truth was histology and a 6-month follow-up.

Results: Nine patients (12 lesions) presented BAC or adenocarcinoma with BAC features, two patients presented adenocarcinoma without BAC features (five lesions) and four patients presented benign lesions (15 non-malignant sites). For both FCH and FDG, patient-based sensitivity was 78% for detecting cancer with a BAC component and 82% for detecting malignancy. Site-based sensitivity for detecting malignancy was 76 and 75% for detecting cancer with BAC features, for both radiopharmaceuticals. Specificity was similar for FCH and FDG (site-based 93 vs. 81%, NS). In these early-stage cancers, only one adrenal metastasis was observed that took up FCH and FDG.

Conclusion: In this population of patients with ground-glass opacities selected on CT suggestive of BAC or with a history of BAC and a recent lung anomaly on CT, FCH detected all malignant lesions with at least a 2.0 cm short axis. However, FDG had similar performance.

Author Information

Departments of aNuclear Medicine

bPharmacy

cPathological Anatomy

dPulmonology, Hôpital Tenon AP-HP, Paris, France

eDepartment of Nuclear Medicine, University Hospital of Bratislava, Slovakia

Correspondence to Dr Sona Balogova, PhD, Department of Nuclear Medicine, l'Hôpital Tenon AP-HP, 59, Rue de la Chine, Paris 75020, France

Tel: +42 190 396 9869; fax: +33 156 016 171;

e-mail: sona.balogova@kapor.sk

Received 24 July 2009 Revised 9 December 2009 Accepted 10 December 2009

© 2010 Lippincott Williams & Wilkins, Inc.