This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Jager, P. L. Articles by Hoekstra, H. J. Search for Related Content PubMed PubMed Citation Articles by Jager, P. L. Articles by Hoekstra, H. J.

Imaging of Soft-Tissue Tumors Using L-3-[Iodine-123]Iodo--methyl-tyrosine Single Photon Emission Computed Tomography: Comparison with Proliferative and Mitotic Activity, Cellularity, and Vascularity¹

Departments of Nuclear Medicine [P. L. J., D. A. P.], Pathology [B. E. C. P., W. M. M.], Medical Oncology [E. G. E. d. V.], Surgical Oncology [H. J. H.], and Positron Emission Tomography Center [W. V.], University Hospital Groningen, 9700 RB Groningen, the Netherlands

The radiolabeled amino acid L-3-[¹²³I]-iodo--methyltyrosine (IMT) is a new tumor tracer that accumulates in many tumors and is suitable for single photon emission computed tomography (SPECT) imaging. Using IMT SPECT, we studied 32 patients with a soft-tissue tumor suspected to be a soft-tissue sarcoma to determine whether: (a) tumors can be visualized; (b) benign and malignant lesions can be distinguished; and (c) IMT uptake is related to tumor grade and proliferation. Whole-body imaging was performed 15 min after administration of 300 MBq IMT, biopsy, or resection 1–2 weeks later. IMT uptake was quantified using a region-of-interest method resulting in tumor:background (T:B) ratios. These were compared with tumor grade, mitotic index, tumor cellularity, vascularity, and the Ki-67 proliferation index. Eleven patients had a benign tumor, and 21 patients had a soft-tissue sarcoma. Six benign tumors demonstrated minor IMT uptake, and five lipomas had no uptake. All malignant tumors had high uptake and were clearly visualized. T:B ratios in malignant tumors (3.83 ± 1.16) were higher (P < 0.001) than in benign tumors (1.52 ± 0.60). Small (<5 mm) metastases in two patients were not detected. Taking the T:B ratio 2.0 as the cutoff level, the sensitivity for detection of malignancy was 100%, and specificity was 88%. IMT uptake correlated with histological grade (r = 0.82; P < 0.001), mitotic index (r = 0.75; P < 0.001), tumor cellularity (r = 0.73; P < 0.01), and with the Ki-67 proliferation index (r = 0.63; P < 0.01). In conclusion, IMT SPECT visualized all soft-tissue sarcomas. Uptake in sarcomas was clearly higher than in benign lesions, yielding 100% sensitivity for detection of malignancy at 88% specificity. Uptake increased with higher tumor grade and higher proliferation rate.

This article has been cited by other articles:

				J. R. Bading and A. F. Shields Imaging of Cell Proliferation: Status and Prospects J. Nucl. Med., June 1, 2008; 49(Suppl_2): 64S - 80S. [Abstract] [Full Text] [PDF]

				P. L. Jager Improving Amino Acid Imaging: Hungry or Stuffed? J. Nucl. Med., September 1, 2002; 43(9): 1207 - 1209. [Full Text] [PDF]

				P. L. Jager, H. J.M. Groen, A. van der Leest, J. W.G. van Putten, R. M. Pieterman, E. G.E. de Vries, and D. A. Piers L-3-[123I]Iodo-{{alpha}}-Methyl-Tyrosine SPECT in Non-Small Cell Lung Cancer: Preliminary Observations J. Nucl. Med., April 1, 2001; 42(4): 579 - 585. [Abstract] [Full Text]

				P. L. Jager, W. Vaalburg, J. Pruim, E. G.E. de Vries, K.-J. Langen, and D. A. Piers Radiolabeled Amino Acids: Basic Aspects and Clinical Applications in Oncology J. Nucl. Med., March 1, 2001; 42(3): 432 - 445. [Abstract] [Full Text]

				S. M. Larson Molecular Imaging in Oncology: The Diagnostic Imaging "Revolution" Clin. Cancer Res., June 1, 2000; 6(6): 2125 - 2125. [Full Text]