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The Experimental and Clinical Study on 18F-FLT in Diagnosis of Non-small Cell Lung Cancer

Author: WangYongHong
Tutor: ChenWenXin
School: Fujian Medical
Course: Medical Imaging and Nuclear Medicine
Keywords: F-FLT F-FDG PET / CT Lung adenocarcinoma cell Cell proliferation Non - small cell lung cancer
CLC: R734.2
Type: Master's thesis
Year: 2010
Downloads: 34
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Abstract


Objective: observed tracer 18F-FLT uptake in vitro lung adenocarcinoma SPC-A1 cells different division cycle, to understand the relationship between tumor cell proliferation and 18F-FLT uptake. 2, to explore the diagnostic value of 18F-FLT PET-CT in the space-occupying lesions in the lungs. Method: 1, through drug intervention-induced blocking cell proliferation cycle G2 / M phase, S phase, G0/G1 phase based sample of each batch, a total of three batches. The number of cells of each of the flasks was approximately 5 × 106, incubated for 60 minutes after each bottle was added 1.85 × 105Bq (5μCi) 18F-FLT, washed 2 times with PBS solution and collect adherent cells, and then digested with 0.25% trypsin, digestive , made from a single cell suspension. Were divided into two parts, a portion of the cells were centrifuged, fixed, made by flow cytometry 24 hours of each of the synchronization ratio, expressed as a percentage of each cycle, the cell construct; another part of the cells was measured in a γ-counter γ-counts 1.85 × 105Bq 18F-FLT exclude each batch of the determination of the starting time on the count rate in each set at the same time the standard pipe, uptake rate per 106 cells of radioactivity count with standard pipe count represents a percentage value. 2, retrospective analysis from December 2007 to December 2009, Fujian Provincial Hospital, Department of Nuclear Medicine, PET / CT center line of 18F-FDG and 18F-FLT PET-CT imaging in 20 cases, including 12 males and 8 females patients aged 30 years old to 88 years old, the average age of 61.33 ± 16.94 years; lesions less than or equal to 3 cm in 11 cases, 9 cases greater than 3 cm. 18F-FDG and 18F-FLT imaging in patients under the same conditions, the the two imaging interval time in less than three days, respectively, both PET imaging agents for visual analysis and semi-quantitative analysis, which 18F -FDG standard with a vicious SUV gt; 2.5 18F-FLT standard to adopt vicious SUV gt; 1.35. Among them, 15 patients with pathological results, the other five cases were followed up for more than six months. Results: 1, 1 × 106 individuals outside the lung adenocarcinoma SPC-A1 cells 18F-FLT uptake rate and the percentage of cells in S phase cells significantly correlated (r = 0.642, P lt; 0.01), and the cells within the G2 / the percentage of M phase cells also showed a significant correlation (r = 0.695, P = 0.001). 2, S-phase cells of 18F-FLT uptake rate than the G2 / M phase cell uptake is high and there is a significant difference (P lt; 0.05). 3,20 patients in 18 cases of lung single shadow or nodules, 2 patients were 2 and 3 lesions. 16 malignant lesions, 15 cases were seen in significant 18F-FDG uptake, only one case of bronchioloalveolar cell carcinoma of 18F-FDG uptake mild 9.19 ± 4.75, the average SUVmax of 18F-FDG in patients with malignant lesions, benign lesions 18F-FDG average SUVmax was 3.05 ± 1.18, compared between benign and malignant lesions were significantly different (P lt; 0.05); lung lesions are generally lower than 18F-FLT uptake of 18F-FDG and malignant lesions of 18F-FLT SUVmax 3.39 ± 1.27 18F-FLT SUVmax of benign lesions was 1.45 ± 0.64. Between benign and malignant lesions significant differences (P lt; 0.05). In four cases of benign lesions, of which only one case of 18F-FDG the SUVmax gt; 2.5, 18F-FLT the SUVmax gt; 1.35. Lesions less than or equal to 3 cm groups of 18F-FDG SUVmax of 6.40 ± 3.04,18 F-FLT SUVmax was 2.50 ± 1.13; 18F-FDG SUVmax greater than 3 cm group 11.40 ± 5.86,18 F-FLT SUVmax was 4.11 ± 1.22 ; lesions greater than 3 cm groups of 18F-FDG and 18F-FLT SUVmax greater than lesions less than or equal to 3 cm group, between the two groups, there were significant differences in sex (0.01 lt; P lt; 0.05). The sensitivity of 18F-FLT and 18F-FDG for the diagnosis of lung cancer, specificity, and accuracy were 75% vs100%, 93.75% vs95%, 95% vs100%. The mediastinal lymph 18F-FDG and 18F-FLT uptake auxiliary judgment benign and malignant tumors of the sensitivity, specificity, accuracy, respectively 92.3% vs76.9%, 50% vs75%, 92.9% vs92.9% respectively. Conclusion: 1, SPC-A1 cells of lung adenocarcinoma in vitro uptake of tracer 18F-FLT and cells in which cell cycle-related, and higher cellular uptake in S phase, suggesting that 18F-FLT PET / CT significantly image change on an accurate evaluation of the effect of chemotherapy for lung adenocarcinoma will have important applications. 2,18 F-FDG and 18F-FLT sensitivity of the diagnosis of lesions and lesion size the lesions greater the sensitivity of the higher; sensitivity of 18F-FDG diagnosis of pulmonary malignant nodules compared with 18F-FLT, but low specificity, The differential diagnosis of benign and malignant nodules of the lungs ability of 18F-FLT compared with 18F-FDG.

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