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Positron Emission Tomography with [18F]-3′-Deoxy-3′fluorothymidine (FLT) as a Predictor of Outcome in Patients with Locally Advanced Resectable Rectal Cancer: a Pilot Study

Molecular Imaging and Biology volume 15, pages 106–113 (2013)Cite this article

Abstract

Purpose

This pilot study was performed to evaluate whether tumor uptake of 18F-labeled 3′-deoxy-3′fluorothymidine (FLT), a proliferative radiotracer, at baseline and early during therapy, is predictive of outcome in locally advanced rectal cancer.

Procedures

Fourteen patients underwent positron emission tomography (PET) with 2-deoxy-2-[18F]fluoro-d-glucose (FDG) and FLT before therapy and PET with FLT approximately 2 weeks after initiating neoadjuvant chemoradiotherapy. FLT and FDG uptake were evaluated qualitatively and by maximum standardized uptake value (SUVmax). Tumor FLT and FDG uptake were correlated with disease-free survival (DFS).

Results

Thirteen patients underwent surgery after therapy, one died before surgery with progressive disease. FDG-PET/computed tomography detected regional lymph node metastases in five and FLT-PET was positive in one. High pretherapy FDG uptake (SUVmax ≥ 14.3), low during-therapy FLT uptake (SUVmax < 2.2), and high percentage change in FLT uptake (≥60 %) were predictive of improved DFS (p < 0.05 for all three values).

Conclusion

Pretherapy FDG uptake, during-therapy FLT uptake, and percentage change in FLT uptake were equally predictive of DFS.

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Conflict of Interest

None of the authors has a conflict of interest associated with this manuscript.

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Affiliations

  1. Division of Nuclear Medicine, Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO, USA

    Farrokh Dehdashti & Barry A. Siegel

  2. Alvin J. Siteman Cancer Center, Washington University School of Medicine, St. Louis, MO, USA

    Farrokh Dehdashti, Perry W. Grigsby, Robert J. Myerson & Barry A. Siegel

  3. Department of Radiation Oncology, Washington University School of Medicine, St. Louis, MO, USA

    Perry W. Grigsby & Robert J. Myerson

  4. Department of Pathology, Washington University School of Medicine, St. Louis, MO, USA

    ILKe Nalbantoglu & Changqing Ma

  5. Washington University School of Medicine, 510 South Kingshighway Blvd., Box 8223, St. Louis, MO, 63105, USA

    Farrokh Dehdashti, Perry W. Grigsby, Robert J. Myerson, ILKe Nalbantoglu, Changqing Ma & Barry A. Siegel

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  1. Farrokh Dehdashti
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  2. Perry W. Grigsby
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Correspondence to Farrokh Dehdashti.

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Dehdashti, F., Grigsby, P.W., Myerson, R.J. et al. Positron Emission Tomography with [18F]-3′-Deoxy-3′fluorothymidine (FLT) as a Predictor of Outcome in Patients with Locally Advanced Resectable Rectal Cancer: a Pilot Study. Mol Imaging Biol 15, 106–113 (2013). https://doi.org/10.1007/s11307-012-0566-y

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  • DOI: https://doi.org/10.1007/s11307-012-0566-y

Key Words

  • Positron emission tomography
  • Rectal cancer
  • Proliferation
  • FLT
  • PET