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PET imaging with [18F]3′-deoxy-3′-fluorothymidine for prediction of response to neoadjuvant treatment in patients with rectal cancer

  • Hinrich A. WiederEmail author
  • Hans Geinitz
  • Robert Rosenberg
  • Florian Lordick
  • Karen Becker
  • Alexander Stahl
  • Ernst Rummeny
  • Jörg R. Siewert
  • Markus Schwaiger
  • Jens Stollfuss
Original Article

Abstract

Purpose

Positron emission tomography (PET) using 18F-labelled 3′-deoxy-3′-fluorothymidine (FLT) was assessed for therapy monitoring in patients with rectal cancer undergoing neoadjuvant chemoradiotherapy.

Methods

Ten patients with locally advanced rectal cancer were included and underwent long-course preoperative chemoradiotherapy (total dose 45 Gy, 1.8 Gy/day, concomitant 250 mg/m2 5-fluorouracil) followed by surgery. FLT-PET was performed prior to chemoradiotherapy, 2 weeks after initiation of chemoradiotherapy and preoperatively (3–4 weeks post chemoradiotherapy). FLT uptake was correlated with histopathological tumour regression and changes in T stage.

Results

Mean tumour FLT uptake was 4.2±1.0 SUV before therapy and decreased significantly to 2.9 ± 0.6 SUV 14 days after initiation of chemoradiotherapy (−28.6% ± 10.7%, p = 0.005). The preoperative scan showed a further decrease to 1.9 ± 0.4 SUV (−54.7% ± 7.6%, p = 0.005). However, the degree of change in FLT uptake 2 weeks after initiation and after completion of neoadjuvant therapy did not correlate with histopathological tumour regression.

Conclusion

FLT-PET did not seem to be a promising method for assessment of tumour response in the studied chemoradiotherapy regimen in patients with rectal cancer.

Keywords

Rectal cancer Therapy monitoring FLT-PET Proliferation 

Notes

Acknowledgements

We acknowledge the efforts of the cyclotron and radiochemistry staff. We appreciate the excellent technical support offered by the technologists at our institution. We thank Jeffrey Fessler, PhD, University of Michigan, for generously providing the software for the iterative reconstruction of the PET studies.

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Copyright information

© Springer-Verlag 2006

Authors and Affiliations

  • Hinrich A. Wieder
    • 1
    • 2
    Email author
  • Hans Geinitz
    • 3
  • Robert Rosenberg
    • 4
  • Florian Lordick
    • 4
    • 5
  • Karen Becker
    • 6
  • Alexander Stahl
    • 1
  • Ernst Rummeny
    • 2
  • Jörg R. Siewert
    • 4
  • Markus Schwaiger
    • 1
  • Jens Stollfuss
    • 2
  1. 1.Department of Nuclear MedicineTechnische Universität MünchenMünchenGermany
  2. 2.Department of RadiologyTechnische Universität MünchenMünchenGermany
  3. 3.Department of RadiotherapyTechnische Universität MünchenMünchenGermany
  4. 4.Department of SurgeryTechnische Universität MünchenMünchenGermany
  5. 5.Department of Medicine IIITechnische Universität MünchenMünchenGermany
  6. 6.Department of PathologyTechnische Universität MünchenMünchenGermany

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