Detection of malignant tumors: whole-body PET with fluorine 18 alpha-methyl tyrosine versus FDG--preliminary study.

PURPOSE To compare the diagnostic potential of whole-body positron emission tomography (PET) with fluorine 18 alpha-methyl tyrosine (FMT) with that of whole-body PET with 2-[fluorine 18]fluoro-2-deoxy-D-glucose (FDG). MATERIALS AND METHODS Nineteen patients with or suspected of having malignant tumors and five healthy volunteers underwent whole-body PET with FMT and FDG. RESULTS In comparison with FDG uptake, FMT uptake was significantly less in the brain, heart, lung, liver, and spine. On a lesion-by-lesion basis, the sensitivity of whole-body FMT PET for depicting malignant tumors was inferior to that of whole-body FDG PET, but this difference was not statistically significant (74% [26 of 35 lesions] vs 91% [32 of 35 lesions], P >.05). The positive predictive value of FMT PET was superior to that of FDG PET (87% [26 of 30 lesions] vs 63% [32 of 51 lesions], P <.001). The difference in uptake between benign and malignant lesions was significant with FMT PET (mean +/- SD, 1.64 +/- 0.96 vs 0.79 +/- 0.23; P <.001) but not with FDG PET (5.02 +/- 3.56 vs 4.02 +/- 2.90, P >.05). CONCLUSION Whole-body FMT PET is clinically useful in the diagnosis of malignant tumors and may be effective in the depiction of primary and metastatic lesions in the cardiac region or in the brain.

[1]  Effect of the duration of fasting on myocardial fluorine-18-fluorodeoxyglucose positron emission tomography images in normal males. , 1996, Japanese circulation journal.

[2]  H. Coenen,et al.  Cerebral metabolism of L-[2-18F]fluorotyrosine, a new PET tracer of protein synthesis. , 1989, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[3]  Masatoshi Itoh,et al.  Estimation of absorbed dose for 2-[F-18]fluoro-2-deoxy-d- glucose using whole-body positron emission tomography and magnetic resonance imaging , 1998, European Journal of Nuclear Medicine.

[4]  Y. Kuwabara,et al.  High [18F]-fluorodeoxyglucose uptake in abdominal abscesses: a PET study. , 1989, Journal of computer assisted tomography.

[5]  Stöcklin Gl.  Is there a future for clinical fluorine-18 radiopharmaceuticals (excluding FDG)? , 1998 .

[6]  H. Groen,et al.  Feasibility of tumor imaging using L-3-[iodine-123]-iodo-alpha-methyl-tyrosine in extracranial tumors. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[7]  T Ido,et al.  Intratumoral distribution of fluorine-18-fluorodeoxyglucose in vivo: high accumulation in macrophages and granulation tissues studied by microautoradiography. , 1992, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[8]  David J. Yang,et al.  Synthesis of isomers of 18F‐labelled amino acid radiopharmaceutical: Position 2− and 3‐L‐18F-α‐methyltyrosine using a separation and purification system , 1997, Nuclear medicine communications.

[9]  R L Wahl,et al.  Pitfalls in oncologic diagnosis with FDG PET imaging: physiologic and benign variants. , 1999, Radiographics : a review publication of the Radiological Society of North America, Inc.

[10]  S. Larson,et al.  Excess Muscle FDG Uptake in an Euglycaemic Patient That Is Corrected by Fasting. , 1998, Clinical positron imaging : official journal of the Institute for Clinical P.E.T.

[11]  M. Pepe,et al.  Comparisons of Predictive Values of Binary Medical Diagnostic Tests for Paired Designs , 2000, Biometrics.

[12]  S. Yasuda,et al.  Cancer screening with whole-body F-fluorodeoxyglucose positron-emission tomography , 1997, The Lancet.

[13]  J. Gilsbach,et al.  Fasting improves discrimination of grade 1 and atypical or malignant meningioma in FDG-PET. , 1997, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[14]  H. Kimura,et al.  Fluorine-18-fluorodeoxyglucose and carbon-11-methionine evaluation of lymphadenopathy in sarcoidosis. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[15]  David J. Yang,et al.  Comparison of fluorine-18-fluorodeoxyglucose and carbon-11-methionine PET in detection of malignant tumors. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[16]  H. Herzog,et al.  Brain and brain tumor uptake of L-3-[123I]iodo-alpha-methyl tyrosine: competition with natural L-amino acids. , 1991, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[17]  K. Ishiwata,et al.  Feasibility of fluorine-18-fluorophenylalanine for tumor imaging compared with carbon-11-L-methionine. , 1996, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[18]  S. Alyafei,et al.  Biodistribution studies on L-3-[fluorine-18]fluoro-alpha-methyl tyrosine: a potential tumor-detecting agent. , 1998, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[19]  Tomio Inoue,et al.  18F α-methyl tyrosine PET studies in patients with brain tumors , 1999 .

[20]  David J. Yang,et al.  Detecting recurrent or residual lung cancer with FDG-PET. , 1995, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[21]  K. Hamacher,et al.  Efficient stereospecific synthesis of no-carrier-added 2-[18F]-fluoro-2-deoxy-D-glucose using aminopolyether supported nucleophilic substitution. , 1986, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[22]  H. Herzog,et al.  SPECT studies of brain tumors with L-3-[123I] iodo-alpha-methyl tyrosine: comparison with PET, 124IMT and first clinical results. , 1990, Journal of nuclear medicine : official publication, Society of Nuclear Medicine.

[23]  W W Souba,et al.  How amino acids get into cells: mechanisms, models, menus, and mediators. , 1992, JPEN. Journal of parenteral and enteral nutrition.

[24]  J Aoki,et al.  Accuracy of standardized uptake value measured by simultaneous emission and transmission scanning in PET oncology. , 1999, Nuclear medicine communications.