Correlation of 18F-FLT uptake with equilibrative nucleoside transporter-1 and thymidine kinase-1 expressions in gastrointestinal cancer

Purpose We examined equilibrative nucleoside transporter-1 (ENT1) and thymidine kinase-1 (TK1) messenger ribonucleic acid (mRNA) expressions in cancer tissue samples to elucidate the mechanism of 3'-deoxy-3'-F-18-fluorothymidine (FLT) uptake by positron emission tomography (PET) scan in gastrointestinal cancer. Methods A total of 21 patients with newly diagnosed gastrointestinal cancer were examined with FLT PET. Tumor lesions were identified as areas of focally increased uptake, exceeding that of surrounding normal tissue. For semiquantitative analysis, the maximal standardized uptake value (SUV) was calculated. The expressions of ENT1 and TK1 in cancer tissue samples were compared with that of FLT SUV. Results Of all gastrointestinal cancer lesions only one gastric cancer showed focally increased uptake of FLT PET. The mean (+/- standard deviation) FLT SUV in gastrointestinal cancer was 5.48 +/- 1.87. There was no significant correlation between FLT SUV and ENT1 (P=0.90) mRNA expression. There was a significant correlation between FLT SUV and TK1 mRNA expression (P<0.05). Conclusion Results of this preliminary study indicate that TK1 activity is an important determinant of FLT uptake in gastrointestinal cancer. In this study, it was found that ENT1 activity and FLT uptake were not related. Nucl Med Commun 32:460-465 (C) 2011 Wolters Kluwer Health vertical bar Lippincott Williams & Wilkins.