PET-CT, Bio-imaging for Predicting Prognosis and Response to Chemotherapy in Patients with Lung Cancer
Positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) is a clinically useful tool for the detection of malignant tumors. However, the uptake of 18F-FDG is not tumor specific; thus, other PET tracers have been developed as imag
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PET-CT, Bio-imaging for Predicting Prognosis and Response to Chemotherapy in Patients with Lung Cancer Kyoichi Kaira Abstract Positron emission tomography (PET) with 2-[18F]-fluoro-2-deoxy-Dglucose (18F-FDG) is a clinically useful tool for the detection of malignant tumors. However, the uptake of 18F-FDG is not tumor specific; thus, other PET tracers have been developed as imaging modalities for human neoplasms. PET tracers, including 18 F-FDG, are used as prognostic and monitoring tools after therapy in lung cancer. In our institution, we developed L-[3-18F]-α-methyltyrosine (18F-FAMT) as an amino acid PET tracer. 18F-FAMT-PET is useful for differentiating malignant from benign lesions, as 18F-FAMT is transported into tumor cells via L-type amino acid transporter 1 (LAT1). This review focuses on the prognostic and clinical significance of 18F-FDG, 18F-FAMT, and other forms of PET imaging after therapy in patients with lung cancer. Keywords 18F-FDG PET • 18F-FAMT PET • Lung cancer • Amino acid transporter • Prognostic factor
3.1 Introduction Lung cancer can be classified as non-small-cell lung cancer (NSCLC) and small- cell lung cancer (SCLC) and is a common malignancy with a poor prognosis after appropriate therapeutic treatment. Performance status (PS) and disease staging are thought to be significant predictors linked to poor outcome after treatment. However, no established biomarker has been discovered for improved outcome after appropriate treatment against lung cancer. Recently, positron emission tomography (PET) imaging has been reported to be a good modality for the detection of malignant lesions in various types of human neoplasm. Previous studies have shown that the accumulation of 2-[18F]-fluoro-2-deoxy-D-glucose (18F-FDG) within tumor cells is K. Kaira, M.D., Ph.D. (*) Department of Oncology Clinical Development, Gunma University Graduate School of Medicine, 3-39-22 showa-machi, Maebashi, Gunma 371-8511, Japan e-mail: [email protected] © Springer Science+Business Media Singapore 2017 Y. Takiguchi (ed.), Molecular Targeted Therapy of Lung Cancer, DOI 10.1007/978-981-10-2002-5_3
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predictive of the efficacy of systemic chemotherapy and prognosis after surgical resection [1–3]. Glucose metabolism, hypoxia, angiogenesis, and cell proliferation have been described as mechanisms of 18F-FDG uptake within tumor cells in previous reports [4, 5]. Here, we review the clinical role of PET-computed tomography (CT) bio-imaging as a predictive marker in patients with lung cancer.
3.2 Prognostic Variables in Patients with Lung Cancer Lung cancer is a leading cause of death worldwide. Surgical resection is the best treatment for patients with early-stage disease, whereas patients with advanced disease are treated with systemic chemotherapy. Although PS and disease stage are novel prognostic factors, there is no established biomarker for predicting prognosis after surgery or chemotherapy in patients with lung cancer. Several studies have found that progressive markers related to angiogenesi
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