Annals of Nuclear Medicine

, Volume 30, Issue 2, pp 89–96 | Cite as

Correlation of 4′-[methyl-11C]-thiothymidine uptake with Ki-67 immunohistochemistry and tumor grade in patients with newly diagnosed gliomas in comparison with 11C-methionine uptake

  • Kenichi Tanaka
  • Yuka YamamotoEmail author
  • Yukito Maeda
  • Hiroyuki Yamamoto
  • Nobuyuki Kudomi
  • Nobuyuki Kawai
  • Jun Toyohara
  • Yoshihiro Nishiyama
Original Article



A novel radiopharmaceutical, 4′-[methyl-11C]thiothymidine (11C-4DST), has been developed as an in vivo cell proliferation marker based on the DNA incorporation method. The purpose of this study was to evaluate 11C-4DST uptake in patients with newly diagnosed glioma and to correlate the results with proliferative activity and tumor grade, in comparison with l-[methyl-11C]-methionine (11C-MET).


Investigations of 11C-4DST and 11C-MET PET/CT were performed retrospectively in 23 patients with newly diagnosed glioma. The maximum standardized uptake value (SUVmax) for tumor (T) and the mean SUV for normal contralateral hemisphere (N) were calculated, and the tumor-to-normal (T/N) ratio was determined. Metabolic tumor volume (MTV) was defined as the volume with a threshold of 40 % of the SUVmax. Proliferative activity as indicated by the Ki-67 index was estimated in tissue specimens.


Of 23 gliomas examined, 11C-4DST PET/CT and 11C-MET PET/CT detected 20 and 22, respectively. Linear regression analysis between 11C-4DST and 11C-MET indicated a weak correlation for SUVmax (r = 0.54, P < 0.008), for T/N ratio (r = 0.56, P < 0.006), and for MTV (r = 0.60, P < 0.003). Linear regression analysis indicated a weak correlation between 11C-4DST and Ki-67 index for SUVmax (r = 0.46, P < 0.03), for T/N ratio (r = 0.43, P < 0.05), and for MTV (r = 0.68, P < 0.001) and between 11C-MET MTV and Ki-67 index (r = 0.43, P < 0.04). Using 11C-4DST, there was a significant difference in SUVmax between grades II and IV (P < 0.03) and in MTV between grades II and IV (P < 0.009) and grades III and IV (P < 0.02). Using 11C-MET, there was a significant difference in SUVmax (P < 0.009) and T/N ratio (P < 0.02) between grades II and IV and in MTV between grades II and IV (P < 0.03) and grades III and IV (P < 0.02).


11C-4DST PET/CT is feasible for imaging of brain gliomas, as well as 11C-MET PET/CT. Especially, it showed the highest correlation coefficient between 11C-4DST MTV and Ki-67 index in newly diagnosed gliomas.


11C-4DST 11C-MET PET Glioma Proliferation 


Compliance with ethical standards

Conflict of interest

None of the authors have any potential conflicts of interest relevant to this article to report.


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Copyright information

© The Japanese Society of Nuclear Medicine 2015

Authors and Affiliations

  • Kenichi Tanaka
    • 1
  • Yuka Yamamoto
    • 1
    Email author
  • Yukito Maeda
    • 1
  • Hiroyuki Yamamoto
    • 2
  • Nobuyuki Kudomi
    • 2
  • Nobuyuki Kawai
    • 3
  • Jun Toyohara
    • 4
  • Yoshihiro Nishiyama
    • 1
  1. 1.Department of Radiology, Faculty of MedicineKagawa UniversityKita-gunJapan
  2. 2.Department of Medical Physics, Faculty of MedicineKagawa UniversityKita-gunJapan
  3. 3.Department of NeurosurgeryKagawa General Rehabilitation HospitalTakamatsuJapan
  4. 4.Research Team for NeuroimagingTokyo Metropolitan Institute of GerontologyItabashiJapan

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