C-11 acetate PET measurement of hypoxia : Correlations with radio sensitivity and multidrug resistance

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C-11 acetate clearance from cancer cell may reflect oxidative metabolism of cancer cell. The purpose of this study was to assess correlations between C-11 acetate clearance and radiosensitivity or multidrug resistance in lung cancer. Correlations between FDG uptake, Tc-99m MIBI clearance and multidrug resistance were also assessed. Dynamic C-11 acetate PET study was performed to estimate C-11 acetate clearance from lung cancer. FDG PET was performed 40 min after injection. Tc-99m MIBI SPECT was performed 15 min and 3 hrs after injection. Radiation effect was estimated by CT study 4 weeks after full dose radiotherapy. Multidrug resistance was estimated by immunohistochemical staining using anti-P-glycoprotein in antibody (JSB-1). There were no significant correlations between C-11 acetate clearance and radiosensitivity or P-glycoprotein expression in lung cancer. However, there was a significant correlatitween FDG uptake and P-glycoprotein expression. Lung cancer with strong P-glycoprotein expression showed low FDG uptake. The Tc-99m MIBI clearance correlated with P-glycoprotein expression. Lung cancer with strong P-glycoprotein expression showed high Tc-99m MIBI clearance. These results indicate that both FDG uptake and Tc-99m MIBI clearance may reflect P-glycoprotein expression in lung cancer.