Imaging Cellular Proliferation During Chemo-Radiotherapy: A Pilot Study of Serial {sup 18}F-FLT Positron Emission Tomography/Computed Tomography Imaging for Non-Small-Cell Lung Cancer

Journal Article · Sun Nov 15 00:00:00 EST 2009 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2008.12.039· OSTI ID:21367507

Everitt, Sarah ^[1]; Hicks, Rodney J ^[2]; Ball, David ^[3]; Kron, Tomas ^[4]; Schneider-Kolsky, Michal ^[5]; Walter, Tania; Binns, David ^[2]; Mac Manus, Michael ^[3]

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1. Radiation Therapy Services, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia)
2. Centre for Molecular Imaging, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia)
3. Division of Radiation Oncology, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia)
4. Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne, Victoria (Australia)
5. Department of Medical Imaging and Radiation Sciences, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria (Australia)

Purpose: To establish whether {sup 18}F-3'-deoxy-3'-fluoro-L-thymidine ({sup 18}F-FLT) can monitor changes in cellular proliferation of non-small-cell lung cancer (NSCLC) during radical chemo-radiotherapy (chemo-RT). Methods and Materials: As part of a prospective pilot study, 5 patients with locally advanced NSCLC underwent serial {sup 18}F-FLT positron emission tomography (PET)/computed tomography (CT) scans during treatment. Baseline {sup 18}F-FLT PET/CT scans were compared with routine staging {sup 18}F-FDG PET/CT scans. Two on-treatment {sup 18}F-FLT scans were performed for each patient on Days 2, 8, 15 or 29, providing a range of time points for response assessment. Results: In all 5 patients, baseline lesional uptake of {sup 18}F-FLT on PET/CT corresponded to staging {sup 18}F-FDG PET/CT abnormalities. {sup 18}F-FLT uptake in tumor was observed on five of nine (55%) on-treatment scans, on Days 2, 8 and 29, but not Day 15. A 'flare' of {sup 18}F-FLT uptake in the primary tumor of one case was observed after 2 Gy of radiation (1.22 x baseline). The remaining eight on-treatment scans demonstrated a mean reduction in {sup 18}F-FLT tumor uptake of 0.58 x baseline. A marked reduction of {sup 18}F-FLT uptake in irradiated bone marrow was observed for all cases. This reduction was observed even after only 2 Gy, and all patients demonstrated a complete absence of proliferating marrow after 10 Gy. Conclusions: This proof of concept study indicates that {sup 18}F-FLT uptake can monitor the distinctive biologic responses of epithelial cancers and highly radiosensitive normal tissue changes during radical chemo-RT. Further studies of {sup 18}F-FLT PET/CT imaging during therapy may suggest that this tracer is useful in developing response-adapted RT for NSCLC.

• OSTI ID: 21367507
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Vol. 75, Issue 4; Other Information: DOI: 10.1016/j.ijrobp.2008.12.039; PII: S0360-3016(09)00024-8; Copyright (c) 2009 Elsevier Science B.V., Amsterdam, The Netherlands, All rights reserved.; ISSN 0360-3016
• Country of Publication: United States
• Language: English

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62 RADIOLOGY AND NUCLEAR MEDICINE
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POSITRON COMPUTED TOMOGRAPHY
RADIOTHERAPY
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