Objective: To evaluate the expression of glucose transporters (Gluts) 1 and 3 in Hodgkin and nonHodgkin lymphoma and to assess the association between their expression and the tumor intensity on 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET).
Methods: All 31 lymphoma patients in whom the histologic diagnosis was made and who had also undergone a prechemotherapy PET scan at our institution between June 2001 and December 2005 were included in this retrospective study. The percentage of tumor cells in the various lymphoma subtypes was estimated by comparison of hematoxylin and eosin stain with a lineage-associated immunohistochemical stain on the same block of tissue. Tissue specimens were stained with Glut1 and Glut3 antibodies. The percentages of Glut1+ and Glut3+ cells in the entire cell population (lymphoma cells and nonlymphomatous cells) and among the lymphoma cells were estimated. FDG PET images were reviewed and the tumor intensity was assessed by calculating the maximum standard uptake value (SUVmax). Correlation coefficients between SUVmax and the percentage of Glut1+ and Glut3+ cells in the entire cell population were calculated.
Results: In all 31 cases, tumors were visible on FDG PET and positive for Glut1 and Glut3. The correlation between the percentage of Glut1+ cells and SUVmax was statistically significant across all 31 cases (r = 0.73, P<0.0001, 95% confidence interval: 0.50-0.86) and across the 25 cases of nonHodgkin lymphoma (r = 0.71, P<0.0001, 95% confidence interval: 0.44-0.87). There was no statistically significant correlation between the percentage of Glut3+ cells and SUVmax. More importantly, in 16 of 31 cases (52%), only nonlymphomatous, benign cells expressed Glut1 or Glut3.
Conclusion: Intensity of lymphoma on FDG PET is likely associated with Glut1 expression. The nonlymphomatous, benign cells may play an important role in visualization of lymphoma on FDG PET.